HIV Debate: Circumcision for African Men?

Is it a lifesaving procedure, or could it make the epidemic worse?

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(The Root) -- Among those in Washington, D.C., for this week's International AIDS Conference, there's little to no debate about whether the world community should do what it takes to stop the global pandemic. But when it comes to how that goal should be accomplished, even those who care most passionately about the issue can disagree.

Case in point: The issue of voluntary medical male circumcision, known as VMMS. Depending on whom you ask, it's either a lifesaving procedure or "torture" that could have the unintended side effect of discouraging condom use and fueling the spread of the disease.

Secretary of State Hillary Clinton, in her opening remarks, announced the Obama administration's support for VMMS as a tool in the fight against the global spread of HIV and AIDS, telling attendees:

On male circumcision, we've supported more than 400,000 procedures since last December alone. And I'm pleased to announce that PEPFAR will provide an additional $40 million to support South Africa's plans to provide voluntary medical circumcisions for almost half a million boys and men in the coming year. You know, and we want the world to know, that this procedure reduces the risk of female-to-male transmission by more than 60 percent and for the rest of the man's life, so the impact can be phenomenal.

In Kenya and Tanzania, mothers asked for circumcision campaigns during school vacations so their teenage sons could participate. In Zimbabwe, some male lawmakers wanted to show their constituents how safe and virtually painless the procedure is, so they went to a mobile clinic and got circumcised. 

Her position is echoed by UNAIDS, the World Health Organization, PEPFAR, the Bill and Melinda Gates Foundation, the World Bank and the Ministries of Health from 14 African countries, who have, according to a PEPFAR press release, committed to a five-year action framework to accelerate the scale of VMMS.

"Over the next five years, enough men can be circumcised through voluntary medical male circumcision to prevent 3.4 million new HIV infections and save billions in care and treatment," said Benjamin Mkapa, former president of Tanzania.

But just outside the convention center, there was a different take. Protesters held banners reading "Circumcision Is Torture" and "Intact Genitals Are a Human Right."

Natalie Erdossy, 29, an activist from Reston, Va., told the Washington Post that circumcision won't end AIDS and that it can lull men into thinking wrongly that they are protected against the virus. She called the studies indicating that VMMS reduces HIV infection "totally flawed."

"Only condoms protect people from it," she said. "If a man in Africa hears that circumcision can protect him, he'll think, 'Hot dog, now I don't have to use a condom.' "

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