Monday, September 27, 2010

African circumcision

 

Circumcision is practiced by almost all groups in West Africa. In the countries of sub-Saharan Africa, it usually coexists with excision except in the matriarchal societies forming a band across southern Africa between Angola and Mozambique. These societies practice neither circumcision nor excision. Further south, in the southernmost region of the African continent, circumcision practices are explained partly by the migration of patriarchal Bantu societies from equatorial regions.

African circumcision is performed on older children and involves a relatively stereotyped ritual consisting of the following elements in succession:

•    seclusion of the initiate, isolation from women and “unclean” children;

image •    ablation of the prepuce, closely linked to the notion of blood sacrifice;

image •    tests of collective or individual endurance after the circumcision;

image•    wearing of special costumes;

image

•    and sometimes the adoption of a new name marking the child’s true birth.

YouTube has an interesting documentary about African circumcision called “To Become A Man - South Africa”:

Male circumcision is one of the world’s oldest surgical practices; carvings depicting circumcisions have been found in ancient Egyptian temples dating as far back as 2300 BC.

In recent months, the issue of male circumcision and its links to the transmission of HIV has hit the headlines and sparked debates across the world. Trials in Kenya, Uganda and South Africa have now all shown that male circumcision significantly reduces a man’s risk of acquiring HIV.

According to a new study, circumcised men are more resistant to STDs, with the process lowering one's chances of herpes infection by 28%, HPV infection by 35% and HIV infection by 60%. The study took place in Uganda, where the population is battling an AIDS epidemic, but circumcision advocates say the same benefits apply to Western men, and claim that the controversial procedure should be recommended for infants here.

Also, see:

Male circumcision and HIV: a web special series

2 comments:

Aek said...

Unmentioned is the great potential for infection and the ramifications of infections in the third world as a result of the circumcision methods practiced in Africa. In South Africa, dozens to hundreds of teen boys die from this initiation ritual each year. It usually isn't the same as the ones done in the hospitals.

The 3 large HIV studies done in Africa haven't been reproduced in the West, and studies have suggested that it wouldn't impact the MSM population - which is the population most at risk of HIV in the West, not heterosexuals. It stands to reason that circumcision would have limited, if any, effect on slowing HIV rates outside of Africa.

As it is, it's still quite a controversial procedure. There are few surgical procedures that're done on healthy and non-diseased tissues. To advocate the procedure on infants who're unable to consent would be unethical. It's curious how proxy consent (via parents) is even allowed for this.

In regards to lowering one's chances of herpes and HPV, that study wasn't done specifically looking at those infections, but rather collected as an aside of sorts during the HIV trial - so to rely on that data can be questionable. Besides, there's a vaccine now for HPV that does work in men. That vaccine is far more effective at reducing HPV infections than circumcision.

In the past there have been numerous studies that either support or refute circumcision's role in reducing STIs and such. It's likely only a matter of time before another paper comes out to refute this most recent body of literature.

JoeBlow said...

AEK, you are absolutely right. There is no evidence that circumcision will help guard against the spread of STIs in men outside of Africa or of gay men. Thanks for you valuable contribution to this post.

BTW, I am in no way an advocate of circumcision. Though I was circumcised without my consent shortly after birth, I think it is a barbaric and largely unnecessary procedure.