Demand for male circumcision increases across Swaziland

The demand for male circumcision is beginning to "sweep" across Swaziland as people seek ways prevent to the spread of HIV, AFP/Mail and Guardian reports (Blandy, AFP/Mail and Guardian, 2/2).

Data from two studies conducted in Kenya and Uganda released in December 2006 by NIH indicate that routine male circumcision could reduce a man's HIV infection risk through heterosexual sex by about 50%.

According to researchers, male circumcision eliminates the cells most vulnerable to HIV.

In addition, a circumcised penis develops thicker skin that is resistant to HIV infection.

The results of the Uganda and Kenya studies were similar to the results of a study conducted in South Africa in 2005 (Kaiser Daily HIV/AIDS Report, 1/19).

To try to meet the growing demand, doctors at the government hospital in the capital, Mbabane, are being trained and are requested to assist in special "circumcision days," when men can undergo the procedure at no cost.

On those days, roughly 40 men get circumcised, but up to 100 additional men regularly are turned away because of the lack of professional medical staff available to perform the procedure.

According to urologist Adam Groenevald, circumcising 200,000 men will require 40,000 operations to be performed annually for the next five years.

In addition, there are "deeper-rooted and more cultural barriers" to circumcision in Swaziland, as boys in the country traditionally are not circumcised, AFP/Mail and Guardian reports.

Swaziland's health ministry is waiting for advice from the World Health Organization before rolling out a mass circumcision program.

"We have to make the medical establishment and policymakers ready for the go ahead," Groenevald said, adding, "If we are not ready and the go ahead comes, there will be chaos.

A number of unqualified people will start offering circumcisions, and we need to avoid that at all costs."

According to Faith Dlamini of the National Emergency Response Council on HIV/AIDS, the government would focus initially on circumcisions among boys and men ages 15 to 30 who are most vulnerable to HIV transmission.

UNICEF estimates that HIV prevalence among men ages 20 to 30 in the country is almost 50%, which is higher than the national adult prevalence (AFP/Mail and Guardian, 2/2).