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| Male Circumicision in Zimbabwe |
ZIMBABWE – HARARE –19 October 2009-A total of 1 291 men have so far been circumcised under the Ministry of Health and Child Welfare’s pilot circumcision project ahead of the stepping up of the programme next year, officials said.
Zimbabwe has adopted male circumcision as one of its strategies to combat the spread of HIV.
Studies have shown that circumcision reduces the risk of men contracting HIV during heterosexual sex by an average of 60 percent.
Male circumcision is the surgical removal of the foreskin covering the head of the male sexual organ.
Briefing journalists during a male circumcision media workshop in Harare on Thursday, the National HIV Prevention Coordinator in the Ministry of Health and Child Welfare, Dr Getrude Ncube, said 800 circumcisions had been performed at the Zimbabwe National Family Planning Council in Harare by the end of last month.
A total of 234 operations were conducted at the Eye Clinic in Bulawayo, with the remainder coming from other pilot centres at Karanda Hospital in Mt Darwin and Mutare Provincial Hospital.
Most centres were opened in June.
Dr Ncube said that three randomised controlled trials had demonstrated 60 percent lower incidence of HIV infection in circumcised men, hence the promotion of the practice.
“All trials were stopped midway by their respective Data Safety and Monitoring Boards because of the strong protective effect on male circumcision on HIV. The evidence was so overwhelming that there was no need to continue,” she said.
The World Health Organisation (WHO), UNAIDS and health experts are supporting the promotion of male circumcision as part of a strategy to fight the spread of HIV, following the randomised controlled trials in Kenya, Uganda and South Africa.
WHO and UNAIDS have already released policy and programme recommendations on male circumcision and HIV prevention.
Dr Ncube said plans were underway to evaluate the pilot phase in Zimbabwe and develop a male circumcision scale up strategic plan from 2010 to 2015.
The Ministry is working with Population Services International (PSI), SAFAIDS, Gates Foundation, United Nations Children Education Fund and USAID among other partners to implement the programme.
The director of the Institute of Continuing Health Education at the University of Zimbabwe’s College of Health Sciences, Mr Chris Samkange, explained that circumcision reduces the spread of HIV in that it removes the foreskin, which is the major entry point of the virus during heterosexual sex.
He said there was a high density of HIV-1 target cells or (langerhans cells) in the foreskin.
Mr Samkange said research had shown that the inner foreskin is more easily affected than cervical tissue and up to nine times more vulnerable than the external foreskin and penile shaft skin.
Circumcision also causes the keratinisation (hardening) of the skin surface, and promotes more rapid drying which reduces the likelihood of bacterial sexual infections, which in turn reduces the risk of acquisition of HIV.
“All clients are, however, required to abstain from sex for 42 days to ensure complete healing of the wound. It is also recommended that they rest for about a week and be very hygienic to ensure that the wound is not infected,” said Mr Samkange.
Meanwhile, Mr Samkange and other health experts, including Dr Karin Hatzold, the director of HIV Services of PSI Zimbabwe, WHO and Ministry of Health and Child Welfare officials, said male circumcision only reduced the risk of contracting HIV but was not 100 percent effective.
They said circumcision should not replace other known methods of HIV prevention and should be considered as a package, which includes delaying the onset of sex, abstinence, partner reduction, correct and consistent use of condoms, treatment of sexually transmitted diseases and voluntary counseling and testing.-The Zimbabwe Telegraph
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