New York, 13 December 2010 — A new report from the Women’s HIV Prevention Tracking Project (WHiPT), a collaborative initiative of AVAC and the ATHENA Network, features an unprecedented collection of voices from Kenya, Namibia, South Africa, Swaziland and Uganda reflecting on what male circumcision for HIV prevention means for women. It highlights women’s perspectives, advocacy priorities and recommendations on this new prevention strategy.
Making Medical Male Circumcision Work for Women is the first report from WHiPT, which was launched in 2009 to bring community perspectives, particularly women’s voices, to the forefront of biomedical prevention research and the broader response to HIV.
The report highlights community-level support as well as concerns and misperceptions that can hinder effective implementation.
“Women are excited for medical male circumcision because they’re desperate for new prevention options, but they lack detailed factual knowledge of its benefits and risks,” says Cebile Dlamini of Swaziland for Positive Living. “For example, the fact that it only provides partial protection can be overlooked and some women and men believe once a man is circumcised, he is by definition HIV-negative.”
In total, nearly 500 women in HIV-affected communities completed a questionnaire, developed and administered by the women-led WHiPT teams in five countries. Almost 40 focus groups provided additional information about women’s attitudes about medical male circumcision. In each country, research took place in different locales, selected to reflect a diversity of circumcision practices, including communities that practice traditional male circumcision and those that do not circumcise, as well as those practicing female genital mutilation.
The majority of teams conducted their research in settings where male circumcision for HIV prevention had not yet been introduced as part of a national HIV strategy. Therefore many reported perceptions and concerns can be integrated into emerging programs — making this report both timely and urgent.
The Kenyan WHiPT team surveyed women in settings where male circumcision was evaluated in a clinical trial and subsequently introduced. Reports from women reached by the Kenyan WHiPT team underscore women’s fears that male circumcision may lead to changes in men’s behaviors and perception of risk.
“The women reported their partners either adapting or continuing risky behavior after ‘the cut'”, says Carol Odada, from Women Fighting AIDS in Kenya.
The report documents women’s concerns that medical male circumcision might lead to an increase in heightened stigma for women living with HIV. This would be a result of circumcised men’s misperceptions that they could not be HIV positive and/or could not transmit the virus. Thus sex and or safer sex would be less negotiable than before circumcision, putting women at greater risk for gender-based violence and HIV.
The report also highlights perceptions of male circumcision for HIV prevention in the context of traditional practices. Specifically, it underscores the need for communications campaigns that directly address the distinctions between medical male circumcision, traditional circumcision and female genital mutilation.
“Some women report the concern that the promotion of circumcision for men would increase the promotion of female genital mutilation,” says Allen Kuteesa from Health Rights Action Group in Uganda.
The myths and misunderstandings identified by WHiPT teams — such as the perception that medical male circumcision is directly protective for women — underscore the urgent need for adequate education campaigns directed at women. Further, for women to access and act on information related to medical male circumcision and HIV, the information needs to be specifically tailored to women, and the socio-cultural context and realities of women’s lived experience need to be taken into account.
The report summarizes advocacy activities that WHiPT teams will undertake over the coming year to ensure that male circumcision implementation addresses women’s concerns.
To download the report and/or a recording of the global report launch teleforum with the report authors, go to http://www.avac.org/WHiPT.
About WHiPT: The Women’s HIV Prevention Tracking Project (WHiPT) is a collaborative initiative of AVAC and the ATHENA Network launched in 2009 to bring community perspectives, particularly women’s voices, to the forefront of the HIV and AIDS response. The specific purpose of WHiPT is to advance and facilitate the monitoring of HIV prevention research, advocacy and implementation by women who are the most affected by the epidemic. The WHiPT Report was produced by teams led by the AIDS Legal Network, South Africa; the ATHENA Network; AVAC; Health Rights Action Group, Uganda; Mama’s Club, Uganda; Namibia Women’s Health Network, Namibia; Swaziland for Positive Living, Swaziland; and Women Fighting AIDS in Kenya, Kenya.
The fact is, that male circumcision does reduce the risk of HIV, The science is very clear on how and why it is so. The fact is also that many or even most women prefer circumcised men.
But we sit with a nation of people dying by the millions already because of HIV and still many men refuse to accept the facts. Not all medical associations support circumcision as a routine procedure, but they all acknowledge the benefits and the facts as we read them. Then the UN, WHO, UNAIDS, CDC, UNICEF, AAP, NIH, SAfAIDS, PEPFAR, FHI 360, Section27, IWHC, MRC and many global and high ranking health and HIV organisations support the United Nations goal to have 80% men between the ages of 15 and 49 circumcised by 2015 in 14 priority countries. How can all these organisations be wrong about this? The evidence is very strong.
Besides the fact that most women prefer circumcised men, and that circumcision has many other health benefits which cannot be denied.
San Francisco tried to ban male circumcision and they failed, Germany has recently tried to ban male circumcision but they have failed. Even the AAP who was neutral on the matter has now start to encourage it. How can you stop a religion from exercising its culture, it would be discrimination against such an religion. How can you stop a parent from making decisions that will improve their child’s health on the basis of all the recognized scientific evidence? Circumcision is not child abuse or genital mutilation like in the case of FGM. Male circumcision is a recognized medical procedure that can be safely performed with medical benefits. Circumcision is here to stay for health, hygiene, personal preference, religion, culture and a basic right of parents to make informed decisions for the benefit of their children.
I think the program is excellent and can be expanded, it will save millions of lives and the only way I can see these objectives to be reached is if more women are empowered and involved by the program. But both men and women will benefit from this program. I only feel that leaders are dragging their feet, and not enough is done to archive the targets for it to be really effective.
I wonder what the response would be if men were queried about female circumcision? Believe it or not, one study several years ago showed that female circumcision prevented HIV infection.
Male (or female) circumcision will not impact the spread of the disease one whit. These rumor mongers are actually feeding the spread of the disease by making people believe they will be protected to some degree.
Interestingly, other research has shown that circumcised men are far more resistant to wearing condoms more than uncircumcised men. The hypothesis for this difference was that circumcision reduces sensitivity to the absolute minimum level acceptable and condoms reduce the “reward” even further to an unacceptable level so that most circumcised men refuse to wear them.
Time will show that male circumcision does nothing to reduce the spread of HIV and instead of saving millions of lives, millions will die.
The leaders and promoters of this study have more than 25 years history as rabid promoters of male circumcision. This is nothing more than a continuance of their agenda. They should be arrested and hanged for multiple murders.
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Too bad they can’t surgically implant a permanent condom. That might empower women.
Back in 2006, Bill Clinton made the point that empowering women was essential to combating AIDS. This study shows that circumcision DISempowers women at every level – making it harder for them to negotiate condom use, making them to blame for becoming HIV+, and facilitating female genital cutting.
All the while, circumcision has so far (perhaps) delayed a total of 73 HIV infections for less than two years after 5,400 men were circumcised in the three trials. On that fragile point the whole inverted pyramid of claims about “millions being saved” rests. Issues like these could completely undermine any benefits circumcision ever gives.
This story is actually about a comically inept effort NOT to fight HIV, but to promote male circumcision for some bizarre reason.
It’s ironic that Uganda was included in the analysis, because it was there in 2009 that Wawer/Gray showed that circumcising a man INCREASES the risk that he’ll infect his female partner with HIV by 50%.
And Swaziland is another odd choice, since it is one of the many African nations where it is the CIRCUMCISED who have a markedly higher HIV incidence.
Circumcision dis-empowers women because their partners will tell them the man in the white coat told said they were protected from HIV, and no condom is needed. It’s obviously a false concept, as ethical doctors will admit. Most of the US men who have died of AIDS were circumcised at birth. The US, with its mostly circumcised adult population and fine health care and education levels, has THREE TIMES the HIV incidence that Europe has, even though circumcision is very rare in Europe.
Obviously circumcision is neither necessary nor sufficient to thwart AIDS. Promote condom use and heap shame upon these circumcision advocates.