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Will Circumcision Change Behavior or Reinforce Machismo?

by 08/10/2012 11:41:00 0 comments 960 Views

A mood of sober curiosity as dozens of men - young and old-waited for their turn on the surgical table in order to have their foreskins chopped off characterised Harare's Spilhaus Family Planning Centre.

Following research that found circumcision reduces the risk of HIV transmission by as much as 60%, a USAID-supported programme aims to circumcise two million Zimbabwean men by 2015. So far, 55,000 have undergone the procedure.

I volunteered to take part after I received an HIV test and the advice that circumcision helps to prevent HIV and many other diseases.

Before the short surgical operation, all participants are tested for HIV and AIDS and provided with counselling services. They also take part in an awareness discussion about the benefits of circumcision. The discussion appeared to ease the expressions of fear and concern present on most faces in the room.

Just before facing the knife, men must receive a number of anaesthetic injections to their penis. At this point the room filled with the sound of groans and cries, much to the delight of the female medical staff who laughed at the "weak" men in the group.

Gender stereotypes reared their ugly heads and as men, we are expected to maintain composure while we have needles stuck into our penises and then our foreskins chopped off. I clenched my teeth and wondered what I had gotten myself into.

The process is quick and no sooner, the doctor held what appeared to be a huge chunk of my body. I joined many in the room who wondered aloud if they'd ever be able to function again.

Yet almost all the men walked out of the room with an air of triumph. Later I posted news of my seemingly courageous act on Facebook and received mixed reviews from friends. Some asked if I had lost my mind - how could I have fallen for the donor propaganda, they wanted to know. Almost all my female friends, however, praised me for the courageous step.

Circumcision remains a polarising issue, especially between men and women. Many of my female friends realise the obvious health benefits, including a lower risk of HIV infection. For women especially, if their boyfriend or husband is circumcised it lessens the chance he will infect them with HIV should he stray outside the relationship.

Meanwhile, circumcision has gained a groundswell of support in the country and 175 Members of Parliament have now volunteered to undergo the process. In a recent New Zimbabwe article, Blessing Chebundo, Kwekwe MP and chairperson of the Parliamentary Portfolio Committee on HIV and AIDS, said MPs are ready to lead by example. "We will walk the talk as role models and lead by example to embark on voluntary HIV testing and male circumcision, as well as to inspire young people to do the same," he said. "We need to go down to constituencies, provinces, districts, wards and villages to spread messages to fight HIV and AIDS and encourage males to undergo voluntary circumcision."

While some MPs are stepping up to the plate, others, such as Magwegwe MP Magalela Sibanda, believe circumcision is just for youth. He told Newsday: "HIV should be a syllabus for the youths at a tender age not to tell us here in Parliament, when I am already 65-years-old, and you tell me to go and get circumcised when I have sired 18 children without circumcision."

As a government policy, it appears circumcision is reluctantly promoted by some MPs because other health-related and donor-funded initiatives are tied to this programme.

And while the benefits of circumcision have been proven, the temptation of circumcised men to feel "protected" - and hence indulge in unsafe sexual practices - is a dangerous risk likely also increased because of this programme.

A few weeks into my healing process, I heard from a man I'd met at the clinic. He said his organ had healed and wanted to "test" it. He made it clear that he wanted to "test" the organ on a number of sexual partners to be sure the he is "ok."

This illustrates the false attitude among many sexually active circumcised men that circumcision gives them license to take part in multiple sexual liaisons. Messages about the benefits of circumcision do not seem fully integrated into HIV prevention campaigns in a way that underscores the point that even circumcised men are at risk of contracting and spreading the virus. As such, continued emphasis on condom use and, more importantly, the development, awareness and access to HIV preventive methods that give women power over their sexuality, is key.

Circumcision does not necessarily result in male sexual behaviour changes. For many macho men, it might as well be another trophy in the cabinet. Such men have not understood the message that it is but one method of HIV prevention - men still need to be faithful and use condoms.

For now the struggle to address HIV and AIDS remains gender polarising. One can only hope that all circumcised men learn to also put bad behaviour under the knife. My scar is permanent and hopefully a daily reminder of the cost of faithfulness and real commitment to family, partnership and marriage.

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