Background of MC in Zimbabwe
The National AIDS Council (NAC) in collaboration with the Ministry of Health and Child Welfare (MOHCW) convened a large-scale stakeholder consultation in 2007, which recommended considering male circumcision as a public health intervention for HIV prevention. Following this meeting, the MOHCW initiated processes to guide stakeholders in the development and implementation of a Male Circumcision policy, service delivery and communication activities in Zimbabwe. 
What is Male Circumcision?
Male Circumcision (MC) is the surgical removal of the foreskin covering the head of the penis. 
How high is demand for MC within Zimbabwe?
Male circumcision is reported to be generally uncommon among the majority Shona and Ndebele groups. In the only study on male circumcision acceptability in Zimbabwe conducted in Harare (2000), 45% of respondents expressed a wish to be circumcised if the practice was confirmed to reduce the risk of contracting HIV or STIs and if it was performed safely and is affordable . The current demand for male circumcision in Zimbabwe is not clear. However, it is likely to increase as information on the efficacy of male circumcision in HIV prevention becomes more widely known.

Why do men in Zimbabwe go for circumcision?
It is estimated that around 10% of Zimbabwean men are currently circumcised. Male circumcision is undertaken for several reasons including:

• religious reasons among Chewa and Muslims, who constitute approximately 1% of the population (concentrated in Harare);
• cultural/traditional reasons in specific groups which represent a relatively small proportion of the population, such as the Xhosa/“Fengu” of Ntabazinduna, the Tonga of Binga, the Venda and the Shangani of Chiredzi and Mberengwa, who perform it as part of initiation rites of passage to manhood;
• medical reasons.

What are the benefits of Male Circumcision?
MC has been scientifically proven to reduce the chances of men becoming infected with HIV during heterosexual intercourse by 60%. However, MC should be used in conjunction with other prevention methods such as consistent and correct condom use and reduction in number of sexual partners.

MC also offers partial protection against:

• STIs such as herpes, ulcers and discharge of the penis
• Cancer of the penis  
• Urinary tract infections in children
• Cervical cancer in women whose partners are circumcised.

Circumcised men also find it easier to maintain penile hygiene
How does MC reduce the risk of HIV transmission?
The inner part of the foreskin is soft and moist and is more likely to tear or get small bruises and sores that allow HIV and other STIs to enter the body more easily. After MC, the skin on the head of the penis becomes harder and is less likely to tear or bruise, making it more difficult for HIV to enter. 
Even after MC, HIV can still enter the penis, but it is much more difficult for the virus. Because MC does not provide complete protection, circumcised men should continue to use other HIV prevention strategies, including abstinence, reduction in the number of sexual partners, correct and consistent use of male and female condoms and knowledge of status.

How safe is MC?

MC is an operation conducted under local anesthesia and one can go home on the same day, soon after the procedure.
Circumcision is relatively safe, with a low rate of complications, most of which are immediately and easily treated. There are no major risks with this operation when it is performed by a trained person under hygienic conditions at an MC clinic.
One might experience some pain after the operation, but this normally disappears within a few days. Patients will get some pain killers so that they do not experience any pain. In some cases, there might be some mild bleeding after the operation, which is associated with swelling. In this case one should return to the hospital for review of the wound. Very rarely people do people react to the local anesthesia,
The patient must exercise high standards of personal hygiene after the procedure to avoid infection of the wound.  Patients are advised to return to the clinic for review at any time if there is a problem.
How long does it take to heal?
The wound should heal within a period of 6 weeks.  Newly circumcised men should abstain from sex for about 6 weeks to ensure that the penis is fully healed, as they could be at increased risk of infection during this period.  Thereafter, other HIV prevention strategies, including the correct and consistent use of the male and female condoms, reduction of overlapping multiple concurrent partnerships should be adhered to. 
Can an HIV positive man be circumcised?
MC is not recommended for HIV positive men as there are no health benefits to them or their partners in terms of HIV prevention. HIV positive men can still transmit HIV to their partners after MC. Wound healing may also take longer in men who are HIV positive than those who are negative. It is therefore important for one to know their status first before being circumcised to get the maximum health benefit from the procedure.
Where can one get circumcised in Zimbabwe?
Male circumcision will initially be available at the following centres:
Harare :          Spilhaus, ZNFPC Centre - Open
Bulawayo:      Eye clinic – Opening end of June 2009
Mutare:           Mutare Provincial Hospital – Opening end of June 2009
Mt Darwin:     Karanda Hospital, Mt Darwin – Opening end of June 2009.

References
New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications, WHO/UNAIDS Technical Consultation on Male Circumcision and HIV Prevention Report: Montreux 6 – 8 March 2007│http://data.unaids.org/pub/Report/2007/mc_pdf
Male Circumcision: Evidence and Implications, Wilson, D& de Beyer, J. World Bank. (2006) Washington
Male Circumcision & HIV Prevention in Eastern and Southern Africa: Communications Guidance, UNAIDS.
Other Useful Links
www.unaids.org/en/PolicyAndPractice/Prevention/MaleCircumcision/defalut.asp
http://www.malecircumcision.org/