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High Demand For Circumcision In AIDS-Hit Swaziland

Circumcision makes it comeback in Swaziland, years after it was banned by a king who reigned during the 19th century// The religious practice was apparently banned as the king (King Mswati II) felt that men recovering from the surgical procedure were diverted from waging war.

This situation has however, changed now. Thanks to the AIDS research that showed that the ritual may help restrict the spread of the HIV/AIDS virus. A number of clinics in the city are now overcrowded with volunteers, ready to shear their foreskin.

The tiny African kingdom that houses nearly 1 million people has the highest rates of HIV incidence with over than 40% of the adult population infected with HIV. A majority of the Swazis work in the mines in South Africa where polygamy is commonplace. Another reason could be the lowest circumcision rates prevalent in Swaziland.

Although researchers have cited some associations between high rates of HIV incidence and low rates of male circumcision, it was not until 1980 that a definitive link was established. This was possible through a South African study which proved that circumcision decreased the chances of HIV transmission by as much as 60%. This could probably be attributed to the foreskin, which, harbors cells that the virus seems to infect readily.

Following publication of the results and awareness campaigns, there has been an increased tendency to undertake circumcision on a voluntary basis. Mothers play a crucial role in urging their sons to get circumcised. Mbabane clinic that used to perform less than 1 circumcision a month prior to the study now performs nearly 10 circumcisions a week.

The practice of circumcision is widely practiced in United States to prevent urinary tract infections and sexually transmitted infections. In countries other than the United States, it is taken up for religious and cultural reasons. The health officials in Swaziland are concerned that advo cating circumcision could lead to the false impression that circumcision is equivalent to wearing a permanent condom. This could devastate all the anti-AIDS efforts.

Consistent with the fear, increased sexual activity has been documented in circumcised men soon after the surgical procedure. The health officials also fear that it could pave way for such procedures to be performed by inappropriately trained practitioners at a cheap rate.

The distinct advantage of the procedure is that it is a single-shot procedure and is much easier than convincing a man to wear a condom during every sexual contact. Whether the practice of circumcision would guarantee a reduction in AIDS/HIV incidence in Swaziland is a question best answered by time.


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