The East African Standard has a very nice piece.
http://www.eastandard.net/hm_news/news.php?articleid=1143972702Debate on link between HIV and circumcision gains tempo
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By Elizabeth Mwai
The raging debate on the relationship between the spread of HIV/Aids virus and male circumcision has gained new tempo.
It is a duel between long cherished tradition and medical science. The scientific evidence remains incontrovertible. One study commissioned by the governments of Kenya, Uganda and South Africa, under the auspices of a UN agency, showed that circumcision could halve men’s vulnerability to HIV from having sex with infected women.
The Government and the donor community now seek to inculcate a change in attitude without appearing to ignore culture. The attitude change plan is based on studies that show the male cut can significantly reduce chances of contracting HIV by as much as 60 per cent.
Last month, Kenya was among the 130 countries gathered in Sydney to discuss findings that male circumcision could reduce the risk of HIV infection.
The over 5,000 delegates attending the four-day conference heard evidence presented from a study in Kenya and Uganda confirming the findings of a previous study in South Africa, that male circumcision can reduce the risk of HIV infection among young men.
Luo community objects to circumcision
But Mr Meshack Riaga, the chairperson of the Luo Council of Elders, insists that scientific discoveries would not sway him to adopt a practice that was not deemed necessary by their forefathers.
A staunch believer in abstinence, Riaga says male circumcision alone cannot tackle the spread of new infections.
"Abstinence is the ultimate weapon," he says.
Riaga, 72, says his Luo community objects to circumcision regardless of what studies show about the chances of contracting HIV/Aids.
"I object to circumcision because it is not our way of life," he says.
Experts believe cells found on the foreskin, the part of the inside of the male organ cut off during circumcision, are particularly susceptible to HIV infection.
The Ministry of Health has embarked on a policy formulation process that will see the "cut" entrenched into the HIV prevention strategy.
Dr Ibrahim Mohamed, director, National Aids and Sexually Transmitted Infections Control Programme, says: "There is a committee working on the policy to include circumcision into the HIV prevention strategy".
Apart from the Luo, Turkana and Teso, all other communities in Kenya practice male circumcision.
Circumcision makes the glands more resistant to viral entry
The trials in Kenya and Uganda each involved 2,000 heterosexual men, half of whom were circumcised.
Experts want experienced surgeons to undertake the cut, which they insist, should be accompanied by awareness.
Male circumcision makes the glands more resistant to viral entry.
"We are in recognition that male circumcision is protective in the transmission of HIV/Aids, so we need guidelines in the country on how it should be done," Mohamed said.
But he is quick to explain that circumcision is not 100 per cent effective and should be accompanied by other protective measures.
He notes that male circumcision has always served cultural purposes, and hence, the need to form a policy to combine the other benefits.
Attitude change should be the best recommendation
Many Kenyans have died of HIV/Aids complications, including TB, while two million children have been orphaned.
Circumcision remains a natural way out, says the medic, but the Luo Council of Elders will have none of it. Promoting male circumcision as a tool to prevent HIV/Aids infections, says Riaga, will fuel prostitution, as people will indulge in careless sex.
"And the only reasonable way of dealing with it is through behaviour change," says the elder.
And the Kenya Medical Association (KMA) supports Riaga’s views. KMA chairman Dr Stephen Ochiel says, "Attitude change should be the best recommendation. Some men believe circumcision gives them a leeway to have multiple partners," says Ochiel.
The US has pledged to give Kenya more than Sh25 billion to fight HIV/Aids and promote male circumcision. About Sh350 million of the amount is earmarked for advocacy.
Despite all this money, the cultural barrier is huge.
Emotions are the greatest enemy of rational arguments