Zuzimplio opened doors three years ago and offered Jo’€™burg residents and surrounding areas affordable private HIV and AIDS care. Patients could get a complete package of services including CD 4 count and viral load tests and antiretroviral therapy for R350 a month. Now the centre has added medical male circumcision to its package.

‘€œWe’€™ve added circumcision because it’€™s been shown in several randomized controlled trials, which are the gold standard for medical interventions, that circumcision prevents HIV acquisition in young men. If you’€™re circumcised as a man ‘€“ you don’€™t have to be young ‘€“ you have less chance of getting HIV. It reduces your chance by about 50 ‘€“ 60%’€, said Dr Neil Martinson of Wits University’€™s Perinatal HIV Research Unit (PHRU) and founder of Zuzimpilo Clinic.

In offering the service, Martinson emphasises that medical male circumcision does not guarantee safety from contracting HIV. He warns men against throwing caution to the wind and not using condoms once circumcised.                  

‘€œIn the jargon of medicine, it’€™s called disinhibition’€¦ I guess it’€™s like if you’€™re riding a motor-bike and you put on a crash helmet, you’€™re likely to ride faster. And so, the concern is that people who are circumcised may then think they have a natural condom, which isn’€™t the case. It is not the case that you have a natural condom. This provides partial protection. People who are circumcised must still use condoms’€, he said.                          

Although policy on medical male circumcision has been propelled by scientific studies which have shown that it can reduce HIV infection in men, the removal of the foreskin is beneficial for various medical and personal reasons.

‘€œFirstly, people regard it as being cleaner and more hygienic. The second is that it does prevent some sexually transmitted infections. Sexually transmitted infections are a co-factor for HIV transmission. So, if you’€™re preventing some sexually transmitted infections that may be one of the reasons why HIV is transmitted less when somebody is circumcised. The third thing is that the partners of men who are circumcised have less cervical cancer.

There is less transmission of a virus called Human Papilloma Virus (HPV), which has been implicated in the causation of cervical cancer.   The other thing that we find why people like circumcision ‘€“ it’€™s our impression and there is some research to show it ‘€“ is that women prefer men who are circumcised. I’€™m not sure why that is, but it seems that women prefer this’€, Martinson explained.

South Africa recently added medical male circumcision to its HIV prevention measures, targeting younger men. KwaZulu-Natal, the Northern Cape and Mpumalanga are the first to offer the service in public health facilities. Other provinces are still working on their roll-out plans. In Gauteng, Zuzimpilo Clinic is one of a number of private sector health providers who provide the service. The procedure costs R400.