When Uganda is considering its policy on promoting circumcision to combat AIDS it would be prudent to consider the implications of a mass circumcision program.

Firstly, the most that can be said for circumcision is that it reduces the chances of a man catching HIV and perhaps some other infections. It does not eliminate the risk completely. Campaigns that promote safer sexual practices and the use of condoms have a good track record in bringing down HIV infection rates in communities. It would be a tragedy if proven methods of HIV control were replaced by this one intervention.

Secondly, whatever advantages may be claimed for circumcision, it is inevitable that some men would not be prepared to have this procedure. Doctors and governments may recommend, but it is for the individual to decide whether he wants to be circumcised or not. in Rwanda, the BBC News reported: “The program will be voluntary, but those in the army likely will see circumcision promotion as an order.” ‘Rwanda Launches Male Circumcision Campaign To Help Reduce Spread Of HIV,’ Medical News Today, 25 January 2008 Compulsory circumcision means forced circumcision, and this would be a human rights violation and quite counterproductive.

Thirdly, while medical circumcisions might be relatively safe, circumcisions performed by untrained operators are not so. A circumcision drive is likely to attract the some shady characters who will prey on the unwary. Untrained operators may actually spread HIV rather than preventing it. The public needs to be warned against untrained operators.

Fourthly, newly circumcised men may be more vulnerable to HIV until the wound completely heals. Men need to be warned about this fact.

Male circumcision might reduce the chance of HIV infection but it is far from a magic bullet. A gung-ho approach to spreading circumcision is bound to cause serious problems; a softly, softly approach, with continued emphasis on proven methods of HIV control: Abstinence, Be faithful and Condoms, is likely to be far more effective.

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Circumcision can only possibly help men who have unsafe sex with HIV+ partners, so why this bizarre obsession with genital surgery when we know that ABC works better than circumcision ever could? (ABC=Abstinence, Being Faithful, Condoms). The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circed men than intact men, yet they've just started a nationwide circumcision campaign. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision, and their actions will cost lives.

Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that.