Africa Asia Middle East عربي Français free subscription IRIN Site Map RSS find PlusNews on facebook follow PlusNews on twitter
Global HIV/AIDS news and analysis
Advanced search
 Sunday 19 December 2010
Weekly reports 
In-Depth reports 
Country profiles 
Fact files 
Most read 
Print report Share |
KENYA: Counselling key to success of male cut

Male circumcision reduces a man's risk of contracting HIV through vaginal sex by up to 60 percent
KISUMU, 2 November 2010 (PlusNews) - When Kenya launched its national voluntary male circumcision campaign in 2008, critics worried that it could lead to greater sexual risk-taking - but men in the western Nyanza Province seem to be disproving this theory.

"When I heard people say male circumcision helps in reducing HIV infection, I went there with the sole purpose that it would lessen the burden of having to use a condom," said 23-year-old Victor Oluoch. "But after that, I have known a lot through the counselling I received; I use a condom every time with anybody... I am not married so I am not going to trust anybody."

A key component of Kenya's programme, which aims to circumcise more than one million men by 2013, is HIV testing and compulsory counselling on HIV prevention, including messages about the importance of continued condom use, as circumcision does not offer full protection from the virus. This counselling appears to have been effective in preventing a phenomenon known as "risk compensation", whereby an intervention that lowers an individual's HIV risk may cause them to take greater risks through other behaviours.

A small 2010 study by the University of Illinois in Kisumu, capital of Nyanza Province, found that most respondents - whether circumcised traditionally or in health facilities - reported either no behaviour change or improved protective behaviour, such as increased condom use and fewer sexual partners.

The research revealed an understanding among the 30 respondents surveyed that male circumcision only provided partial protection against HIV.

The authors speculated that the low levels of risk compensation were due to the effects of counselling, HIV testing and condom availability.

A separate 2007 study, also conducted in Nyanza, found that circumcised men did not engage in more risky sexual behaviours than uncircumcised men in the first year after the operation.

Sending the right message

Most men in Kenya are circumcised as teenagers during rites of passage into adulthood that do not generally feature HIV education. Paul Wasike was circumcised during the traditional ceremony of western Kenya's Bukusu community, when he was told that after circumcision, he was man enough to have sex with as many girls as he chose.

''You have been having the skin and now when it's not there, you are just curious... you want to test how it [sex] feels without it''
"For people like me who were cut at the traditional ceremony, it is sex and adulthood that was emphasized, but I have heard it being talked about on the radio and everywhere that circumcision cannot prevent you from [getting] HIV unless you use a condom or are faithful," said Wasike.

"There is a need to look at how different types and quantity of HIV prevention counselling among men getting circumcised may lead to different types of risk perceptions and behaviours post-circumcision," Thomas Reiss, lead author of the University of Illinois study, told IRIN/PlusNews. "Those circumcised in traditional ceremonies where there is no prevention counselling might vary in risk perception to those circumcised in institutional settings."

Five of the study's respondents reported that they did engage in risky sexual behaviour after circumcision; one man continued to have unprotected sex with his primary girlfriend but reported using condoms with his two other girlfriends.

Donald Were, 31, a married father of three, did not participate in the study but said curiosity was a major factor in having unprotected sex after circumcision.

"You have been having the skin and now when it is not there, you are just curious... you want to test how it [sex] feels without it," he said. "After knowing, then you turn to a condom. I tried it, but with my wife - I can't try it with somebody I don't trust."

Ultimately, Reiss said, preventing risk compensation was a question of information.

"Some people may be misinformed about the protective effects of male circumcision... others may not understand the actual risks of their behaviour and need to be counselled about the risks of their current sexual behaviour and how they can still contract HIV even if circumcised," he said. "Basically it comes down to getting the correct information about HIV risk and circumcision protection to men and women," he said.


Theme(s): (PLUSNEWS) Education, (PLUSNEWS) Gender Issues, (PLUSNEWS) HIV/AIDS (PlusNews), (PLUSNEWS) Prevention - PlusNews


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

Submit your request
 More on Kenya
KENYA: Walking 26km for a condom
KENYA: HIV prevention jeopardized by PM's call for arrest of gays
HIV/AIDS: MSM groups hail pill to prevent HIV
EAST AFRICA: CEOs lead by example, take public HIV tests
KENYA: Exxxposed! A high-risk porn business
 More on Education
UGANDA: "Sexual network" campaign lacking, says study
ETHIOPIA: HIV risk in a booming construction industry
UGANDA: Ssenga Bernadette Nabatanzi, "We used to put premature babies in underground holes"
ZIMBABWE: Drop in condom use following HIV prevention trial
EAST AFRICA: CEOs lead by example, take public HIV tests
 Most Read 
SRI LANKA: Princey Mangalika: "My neighbours burned my house because they thought I had HIV"
SOUTH AFRICA: Nurses step into ART breach
SOUTH AFRICA: Sihle Motha, "You have this person's life in your hands"
HIV/AIDS: IRIN/PlusNews weekly news and analysis round-up Issue 516 for 17 December 2010
Back | Home page

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

Copyright © IRIN 2010
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.