THIS week, we take a look at male circumcision (MC). I have written on this topic previously but after last week’s presentation by Alick Samona from the Society for Family Health (SFH) during the Media Science Café at Zamcom Lodge in Lusaka, I feel there is more to the topic than what many people think.
Mr Samona gave the following as a brief history of male circumcision:
2500 B.C.     First MC performed
?1500 A.D.    Traditional MC in Southern Africa
Late 1980s    Link between MC and HIV suspected
Aug 2004    UTH/Chainama/George MC Clinics
July 2005     Orange Farm RCT stopped
Sept 2006    Zambia MC Consultative Mtg
Dec 2006    Kisumu and Rakai RCTs stopped
Mar 2007    WHO recommends MC for HIV prev
April 2009    Zambia MC program launched

MC and HIV prevalence
High circumcision (80 per cent)
Kenya    11.6
Congo    7.6
Cameroon    4.9
Nigeria    4.1
Gabon    4.3
Liberia    3.7
Sierra Leone    3.2
Ghana    2.4
Benin    2.1
Guinea             2.1
Senegal              Less than 1
Low circumcision (20 per cent)

Zimbabwe    25.8
Botswana    25.1
Namibia    19.9
Zambia    22.0
Swaziland    18.5
Malawi    14.9
Mozambique    14.2
Rwanda    12.8

MC Facts
*Globally, about 30 per cent of men are circumcised.  (Africa about 68 per cent:   Zambia (22 per cent).
*  Done for cultural and religious reasons (and for ‘health’/hygiene)
*  Simple procedure that confers many benefits.
*  But being a surgical procedure it has risks
* Benefits of MC outweigh the risks.
Benefits of MC
MC Prevents:
• HIV infection in men
• Urinary tract infections in infants
• Ulcerative STIs (balanitis, syphilis, chancroid, HSV2)
• Human Papilloma Virus (HPV)
• Cancer of the penis
• Cervical cancer in female partners
Hygiene
The current target for Zambia under the voluntary medical male circumcision is 1.9 million for 2015, but the target is not being met for various factors and reasons. The programme is voluntary hence, no male is forced. The ages 10 to 29 are mainly targeted to be captured as the most active age group though other males are also targeted.
There were 135 facilities for MC in Zambia in 2010 but by 2015, over 470 centres have been established and over 1.100,000 operations performed.
HIV actyivist Danny Lungu said MC should not be taken as a sole preventive measure against HIV.
He gave an example of himself saying he got circumcised at a tender age but still contracted HIV when he became a man.
He said MC helps to protect spouses from contracting the human papiloma virus (HPV) while the partner also enjoys the sexual act as the ejaculation takes a little longer than in men who are not circumcised.
He said people living with HIV should go out in communities to sensitise others about HIV and MC adding that high profile people should always come out in the open about their HIV status to encourage others.
Mr Lungu said disclosure is also important as it helps to do away with stigma.
Until next week.
For comments write to knoxngoma@gmail.com or call/text 0955883143