Africa Asia Middle East عربي Français Português Subscribe IRIN Site Map
Global HIV/AIDS news and analysis
Advanced search
 Monday 08 September 2008
Weekly reports 
In-Depth reports 
Country profiles 
Fact files 
Most read 
Really Simple Syndication Feeds 
About PlusNews 
Contact PlusNews 
Print report
AFRICA: Make circumcision safer, say researchers

Photo: Manoocher Deghati/IRIN
More than a third of boys circumcised traditionally experienced complications afterwards
JOHANNESBURG, 2 September 2008 (PlusNews) - The HIV prevention benefits of rolling out large-scale male circumcision programmes could be lost due to a lack of training and resources to carry out the procedure safely.

The World Health Organisation and UNAIDS recommended male circumcision as a HIV prevention strategy in 2007 after clinical trials in Uganda, Kenya and South Africa found the procedure could reduce a man's risk of contracting HIV by as much as 60 percent. But public health experts have expressed concern about whether male circumcision can be safely provided to large numbers of adult men.

Only 1.7 percent of men in Kenya and 3.6 percent of those in South Africa who participated in the highly controlled and well-resourced trials experienced complications after being circumcised.

However, a study carried out in Bungoma district in western Kenya, published in the September issue of the World Health Organisation's monthly Bulletin, has revealed that 35 percent of male participants experienced complications after being circumcised by traditional practitioners, and 18 percent after being circumcised at a clinic.

Out of 1,007 boys interviewed two months after being circumcised, 25 percent had experienced "adverse events", including excessive bleeding, infections and pain while urinating. The researchers estimated that the procedure had resulted in permanent damage to about 6 percent of the boys.

Although traditional circumcision is the norm in Bungoma, more and more parents are taking their sons to be circumcised at public and private clinics. This allowed the researchers to compare the incidence of complications after both traditional and medical circumcisions.

Although more than twice as many traditionally circumcised boys reported suffering an adverse event, researchers described the rate of medically circumcised boys who suffered complications as "very high compared to rates observed in developed countries and in clinical settings".

After interviewing 41 traditional and medical practitioners and observing a number of procedures, they concluded that more formal training was needed, but that many adverse events were also the result of using blunt or unsterilised cutting instruments, and a lack of sufficient sterilisation equipment and material for dressing wounds.

A higher rate of adverse events after procedures in private clinics (22.5 percent) versus public clinics (11 percent) was probably due to private facilities reducing their costs by replacing their instruments less frequently.

The vast majority of men who participated in the clinical trial in Kenya healed within a month, but in the Bungoma study 24 percent of traditional cases and 19 percent of medical cases had still not healed 60 days after the operation.

Apart from this "unnecessary suffering", the authors noted that "Since many of these young men are sexually active, such a long period for healing could expose them to elevated risks of HIV infection through an open wound."

In fact, 4.5 percent of the participants had already engaged in sex by the time they were interviewed. In communities like Bungoma, where circumcision is practised widely, the authors recommended encouraging parents to take their sons to be circumcised at earlier ages, before they became sexually active.

In the past year a number of countries, including Uganda, Kenya, Zambia and Swaziland, have launched national campaigns to start promoting male circumcision as an HIV prevention tool.

Read more:
 At the Cutting Edge - male circumcision and HIV
 Male circumcision - a gamble for women?
 How safe is traditional circumcision?
 The cutting edge (multimedia)
But the authors of the Bungoma study warned that extensive training and resources would be necessary before health facilities in sub-Saharan Africa were ready to start offering safe circumcision services, and called for more attention to be given to making traditional circumcisions safer in the parts of eastern and southern Africa where it is widespread.

"If the practices in these communities continue to be largely ignored, the gains to be achieved by promotion and provision of circumcision for HIV prevention may well be undermined," they concluded.


Theme(s): (IRIN) HIV/AIDS (PlusNews), (IRIN) Prevention - PlusNews


[This report does not necessarily reflect the views of the United Nations]
Print report
FREE Subscriptions
Your e-mail address:

Submit your request
 More on AFRICA
GLOBAL: IRIN/PlusNews Weekly Issue 402, 5 September 2008
AFRICA-UNITED KINGDOM: HIV prevention not reaching UK Africans
GLOBAL: IRIN/PlusNews Weekly Issue 401, 29 August 2008
GLOBAL: IRIN/PlusNews Weekly Issue 401, 22 August 2008
AFRICA: Many children still miss out on treatment
 More on HIV/AIDS (PlusNews)
GLOBAL: IRIN/PlusNews Weekly Issue 402, 5 September 2008
ZIMBABWE: Union provides free ARVs to journalists
UGANDA: Using mobile phones to fight HIV
UGANDA: Drug supply chain problems trigger shortages
AFRICA-UNITED KINGDOM: HIV prevention not reaching UK Africans
Back | Home page

Services:  Africa | Asia | Middle East | Radio | Film & TV | Photo | E-mail subscription
Feedback · E-mail Webmaster · IRIN Terms & Conditions · Really Simple Syndication News Feeds · About PlusNews · Bookmark PlusNews · Donors

Copyright © IRIN 2008
This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States. Republication is subject to terms and conditions as set out in the IRIN copyright page.