Male circumcision

Male circumcision is the surgical removal of the intact foreskin of the human penis.

Intact foreskin is one of the risk factors for HIV transmission from infected women to men

Circumcision is undertaken worldwide for religious, cultural, and social as well as medical reasons (Government of Uganda MOH 2010). Randomized clinical trials, conducted in sub-Saharan Africa; and South Africa (Auvert et al. 2005), showed that male circumcision protects against HIV as well as reduces the incidence of other sexually transmitted infections (STIs), including genital ulcers, human papilloma virus (HPV), and chlamydia in female partners of men.

 

These studies showed that circumcision reduced the risk of heterosexual HIV transmission from an infected woman to a circumcised man by more than 60%. Due to such evidence, in 2007 WHO/UNAIDS

recommended the adoption of male circumcision as part of the comprehensive strategy to reduce

heterosexually-acquired HIV infection in countries with high HIV prevalence and low levels of

male circumcision.

 

In 2010 Uganda launched the safe male circumcision (SMC) policy as part of the

comprehensive strategy on HIV prevention, in addition to the existing strategy of abstinence,

being faithful to one partner, and condom use (ABC). Prior to the launch of this policy, male

circumcision was mainly practiced for socio-cultural reasons as a rite of passage from childhood

to manhood among the Bagisu and Bakonjo ethnic groups; and also as a religious ritual among

the Moslems. The goal of the SMC policy is to contribute to the reduction of HIV and other STIs

through safe male circumcision services (Government of Uganda MOH 2010). In addition, one

of the key objectives of this policy is to establish a research agenda focusing on male

circumcision services for HIV prevention. This policy also recommends the integration of safe

male medical circumcision services in the HIV prevention and sexual and reproductive health

care services. The target population for this policy is all males, including neonates whose parents

and guardians consent to the procedure, while the recommended age for circumcision is before

puberty with a higher preference for age at circumcision below age 1, followed by age 2–9 and

age 10–17, respectively.