KHOPOTSO: In preparation of this report I set about getting men’€™s views on the results of the three studies from Kenya, Uganda and South Africa. Trevor Kaseke, a Zimbabwean banker working in South Africa, is baffled by how the researchers could have arrived at the conclusion that circumcision can have a protection rate of up to 60% against HIV infection in men.

TREVOR KASEKE: You’€™d need to have followed your respondents 24 hours a day to make sure they all acted alike, and it’€™s hard to do. There are so many factors around HIV transmission’€¦ For instance, you would assume that they all engaged in the same sexual practice with, probably, the same frequency. If all the respondents had engaged in sexual practices, preferably with the same people (he laughs), only then can you really narrow it down to say: ‘€œOkay, the only distinguishing thing here is the circumcision, which narrowed it down’€. But I doubt that would have been the case.

KHOPOTSO: Kaseke believes that two variables could have been at play to influence the finding. The first could be that participants in the group that was offered circumcision were more cautious in their sexual practices. And secondly, their sex partners could have been HIV-negative.

In the South African study, conducted in the Vaal area of Orange Farm, more than 3000 men were enrolled and divided into two equal groups. Member of the one group were circumcised, while the others had their fore-skins intact. At the end of the three-year trial, 69 of the participants had become HIV-positive. Forty-nine of these were from the uncircumcised arm of the study, and 20 from the circumcised group. Investigators in the study say all participants were advised to abstain from sex, to be faithful and to use condoms.

Bongani Sodidi, a half Swati and half Xhosa man who lives in Soweto, was raised by his Xhosa mother. In the Xhosa culture, circumcision is almost sacrosanct. He feels indignant that a study can even suggest that male circumcision could be linked to a reduction in HIV risk.

BONGANI SODIDI: I think it’€™s a stupid study they have done. Circumcision was not intended to prevent a man from acquiring HIV. I think it’€™s an insult to Xhosa culture or any culture for that matter.

KHOPOTSO: Supreme, who works for Men as Partners, a programme of Engender Health, welcomes the finding that male circumcision can help prevent HIV. However, he warns that as a practice rooted in the cultures of many African communities as a symbol of manhood and prestige and power, male circumcision should be treated with sensitivity.

SUPREME: The sociological impact on this matter is very great because everyone will speak from their own background ‘€“ cultural impacts are there, religious impacts are there. Within South Africa, most males would believe that circumcision is a rite of passage to manhood’€¦ And it’€™s a very sensitive issue around that matter, whereas there are cultures and tribes within the country that are not having circumcision as part of their culture. So, for those people talking about circumcision as a good thing to practice might be offensive, blasphemous and every other negative word you can put to it.

KHOPOTSO: Dumisani Rebombo is Supreme’€™s colleague at Men as Partners. He also agrees that every effort is needed to prevent more infections. But for him, circumcising men is not the missing link in HIV prevention.

DUMISANI REBOMBO: I, personally, don’€™t think that. I think that we’€™re talking behavioural change, here. If men are socialised to be macho, you can take that to every little corner of the social life. Therefore, if I think I’€™m strong, I’€™m the man, I shouldn’€™t wear a condom, I should have multiple sexual partners and so forth’€¦ for me those are the underlying factors. If we could change behaviour, we wouldn’€™t be worried about medical male circumcision.

KHOPOTSO: Trevor Kaseke, the banker we spoke to earlier is particularly boggled by the way in which the message about the benefits of medical male circumcision is being communicated.

TREVOR KASEKE: I mean, it’€™s the same thing with the diet that the Health Minister is always in trouble over. I’€™m sure the intention is: ‘€œIt’€™s a holistic thing. Eat these vegetables, they help’€. Not: ‘€œJust these vegetables would help’€. But that’€™s how the general country understands it. The same thing with circumcision ‘€“ it’€™s part of a whole prevention thing. Rather just say: ‘€œWe’€™ve found something else that you can do in addition to this and this and this that will prevent your chances, (as) opposed to singling out this one thing and attaching such a high percentage to it.

KHOPOTSO: Bongani Sodidi is afraid that in a country with a high HIV infection rate, such as South Africa’€™s, the study could only potentially add to the problem.

BONGANI SODIDI: What are they saying to circumcised boys and men? Is the study saying: ‘€œGo and have unprotected sex and get AIDS and get killed’€?

KHOPOTSO: The United Nations’€™ AIDS agency, UNAIDS is careful in its assessment of the studies. It says in a statement: ‘€œWe absolutely have to ensure that men and women are aware that male circumcision is not a ‘€˜magic bullet’€™; it doesn’€™t provide total protection and it doesn’€™t mean people can stop taking the safe sex precautions they were already using’€.