The World Health Organization is recommending for all countries with an HIV/AIDS epidemic (the majority of which are African nations) to promote and make available male circumcision programs. Three trials in Africa have shown that circumcised men were 60% less likely to get HIV than those that were not circumcised, confirming this long-standing hypothesis.
Medical experts say circumcision allows for less risk of infection and reduces the high density of Langerhans cells which are especially vulnerable to HIV. Officials are concerned, however, that men will take increased risks in their sex lives after having the procedure. Circumcision is only partially protective, and condom use is still needed to protect against the spread of HIV. This is especially true within homosexual relations where circumcision has not been found to be as effective. Convincing males that they still need to wear condoms after the procedure to prevent the spread of HIV/AIDS is an ongoing struggle for officials.
Religious and social traditions are also a sensitive area when it comes to discussing this procedure, and must be taken under consideration when promoting circumcision. Traditionally, the areas with the highest rates do not practice male circumcision, and the cultural implications could be profound. Only about 1/4 to 1/3 of world male population is circumcised, mostly of Muslim faith, Jewish faith, and American nationality. Also of concern is that the procedure will only be performed safely. Untrained practitioners and unsafe conditions will lead to more complications and more males being reluctant to have the procedure.
In South Africa’s province with the highest HIV infection rate, authorities say they have been overwhelmed by the number wishing for circumcision. Especially in the prison system, the number of volunteers for this procedure has far exceeded expectations. Adding to the increased demand has been the recent lift of the traditional ban on circumcision by the Zulu king that had been in place since the 1800s. The provisional health minister said that over 10,000 men have opted for circumcision in the first 6 months of the program, and the department had a target of 2.5 million circumcisions by June 2014. They are hopeful that this will decrease the spread of HIV/AIDS in the region and contain the epidemic.