Male circumcision as an HIV prevention strategy and implications for women's sexual and reproductive health rights

Abstract

abstract Male circumcision is being vigorously promoted by some as a component of HIV-prevention strategies. While the evidence suggests that circumcision reduces the risk of heterosexually transmitted infection for the circumcised man, it does not appear to have any impact on transmission rates from HIV-positive men to their female partners. Given resistance to the use of condoms, on the basis that they reduce sexual pleasure, and the belief that, on the contrary, circumcision leads to enhanced sexual pleasure, this article explores attitudes to male circumcision from a gender perspective. It looks at the risks associated with it and its relationship with sexual health, including HIV and other sexually transmitted infections (STIs). The subject of circumcision is taboo for women in African communities, where it is practised for cultural reasons, and this perpetuates inequality between men and women. If the belief that circumcision creates a ‘natural condom’ and thus provides protection from HIV increases circumcised men's resistance to condom use, there may be a higher risk of HIV transmission to, and unintended pregnancy for, their partners. While circumcision may have a role in HIV prevention, it is not a ‘natural condom’ and the implications for women's sexual and reproductive rights need to be addressed