Reject circumcision in fight against HIV/Aids

2011-11-23 13:50

One of South Africa’s leading medical scientists wants the country to reject the use of circumcision in the fight against HIV/Aids.

Professor Daniel Ncayiyana, editor of SA Medical Journal, says there is a risk that the roll-out of circumcision will dilute the standard prevention messages and undermine the gains already made in encouraging condom use and behaviour change.

“I’m proposing that South Africa stop the roll out until this new fad has been more thoroughly investigated,” he told City Press this week.

In an article published in the journal, Ncayiyana writes that circumcision gives sexually-active men a false sense of security.

Instead, he says correct and consistent condom use, not circumcision, is the most effective means of reducing female-to-male transmission.

“Circumcision does not prevent HIV – in high prevalence areas it reduces the risk of female-to-male transmission.”

According to Ncayiyana, it has not been shown that circumcision confers lifetime, partial protection.

“What has been proved is that circumcision will offer partial protection for at least two years.”

Ncayiyana believes it is folly to conclude that such evidence justifies a massive roll-out of circumcision as a measure to reduce the rate of HIV infection.

He suggests that individuals should be able to request circumcision as a personal choice but the country should not undertake to roll out an expensive programme with dubious benefits.

“The condom requires no technology, no infrastructure and no special skills, has no ill side effects,” Ncayiyana says, adding that condoms work 99% of the time.

“Let’s stick to that message,” Ncayiyana says.

Health department spokesperson Fidel Hadebe said while they respected prominent people like Ncayiyana, the department expected them to play a positive role by communicating the true facts around circumcision.

“When a decision was taken to incorporate circumcision into our HIV/Aids strategy, we were mindful of the fact that some people might regard it as a silver bullet and abandon other interventions such as condoms,” Hadebe said.

He said that was the reason behind the department’s decision to offer circumcision only after a person has been thoroughly counselled and informed that circumcision was not a licence to engage in reckless and irresponsible sexual behaviour.

According to Hadebe, circumcision is being offered in KwaZulu-Natal and Limpopo and there have not had any adverse incidents thus far.

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