We received a number of comments after my initial posting about the Safe Male Circumcision Programme at IMG.
It’s true that SMC (MMC, VMMC) has its detractors. There are some that do not consider this procedure desirable and others who are concerned that circumcision may in fact lead to an increase in HIV infections and the spread of STIs.
Some have called into question the validity of the initial three research studies, often quoted as the reasons for these national SMC programmes. We welcome further research studies, designed to ensure that these concerns are addressed. As we embark on this programme in Uganda, we are keeping research and evaluation right at the heart of what we do.
When the BBC reported the news that in Zimbabwe MPs were coming forward for SMC, it noted these concerns:
But it is not the whole solution. Promoting safe sex, providing people with HIV testing services and encouraging the use of male and female condoms are all seen as equally important.
Some experts also say there is a danger in sending out a message that circumcision can protect against HIV because it could lead to an increase in unprotected sex.
We agree, it is essential that SMC is made an integral part of a comprehensive prevention programme. We are ensuring that both men and women understand that male circumcision does not give full protection and other preventive measures must still be taken, in particular continued use of condoms and knowing your partner’s status.
We are using the SMC programme as a unique opportunity to reach men who are often not present at our other community health outreaches. We are combining each of the reproductive health messages with the SMC message, covering e.g. HIV, STIs, Family Planning, PMTCT, the need for and importance of ante-natal visits and attended delivery. In that way we hope that both men and women will gain a better, more complete, understanding of all these related matters.
These programmes are hugely important in Uganda. Just this week the Ministry of Health reported new data showing that HIV/AIDS is on the increase:
The number of Ugandans infected with the HIV virus has increased by 100 per cent in the last seven years, it was announced yesterday. Results from the 2011 Uganda AIDS Indicator Survey show that one in every 13 Ugandan adults has HIV. The prevalence rate has surged from 6.4% in 2005 to 7.3%.
Joshua Businge from the AIDS control Program from the Ministry of Health attributed the incidence to multiple sexual partnerships (MCP) and failure to use condoms as one of the major reasons why the figures were going up.
- Safe Male Circumcision (suubitrust.org.uk)
- Male Circumcision Programme in Tanzania reaches 100,000 (suubitrust.org.uk)
- Circumcision for Zimbabwe’s MPs (bbc.co.uk)