Ambitious target for male circumcision

Swaziland's Ministry of Health and Human Services aims to provide circumcision to 80 percent of men aged 15 to 24 in the next five years, in response to the surging number of men requesting the procedure to reduce their risk of HIV.



Circumcision was widely practiced during the 19th century, but it fell out of favour until evidence in the past few years showed that circumcision could reduce a man's risk of contracting HIV by more than half.



Swaziland has the highest HIV prevalence in the world - 26 percent of adults are infected according to UNAIDS - but health ministry studies have shown that men still reject condoms and engage in unsafe sexual practices such as having multiple partners.



Health officials are now encouraging the renewed popularity of male circumcision by devoting publicity and resources to making it more easily available. Around 1,000 men have already been circumcised at the Litsemba Letfu (SiSwati for "our hope") Male Clinic in Matsapha, halfway between the capital, Mbabane, and the central commercial hub of Manzini.



The project is funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Bill and Melinda Gates Foundation, and is the first medical facility specifically for men.



"Litsemba Letfu is more than a circumcision clinic; we offer the minimum package of male circumcision services, which includes HIV counselling and testing and the provision of condoms," said Jessica Greene, technical services director of Population Services International (PSI), the non-profit organization that runs the clinic.



"We are in the process of integrating STI [sexually transmitted infections] treatment and have longer-term plans to integrate a broader range of men's reproductive health services."





















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At the official opening of the clinic last week, Health Minister Bennedict Xaba noted the misconception that circumcised cannot become infected with HIV.



"Male circumcision can reduce the risk to men of acquiring HIV from their sexual activity, but they must also know that it is not a magic bullet. Men who are circumcised, and their sexual partners, must continue to take additional HIV prevention measures," he said.



Bongiwe Zwane, a communications officer at PSI Swaziland, cautioned that male circumcision was "a step forward", not a solution, to Swaziland's AIDS epidemic.



"We use the opportunity of men coming to the clinic to open their eyes to other ways they can protect themselves," she said. "It is also new and good that men are talking to other men about this."



The celebrity endorsement of Okwakhe Dlamini, the reigning Mr Swaziland, has also boosted efforts to promote male circumcision. Dlamini agreed to write a weekly diary of his experiences after undergoing the procedure for the Swazi News, a local newspaper, and has done spots for national radio and addressed students at tertiary education institutions.



"My phone has been ringing off the hook with even people I haven't spoken to in ages wanting to find out what it's like," he told IRIN/PlusNews. "My loved ones, my parents, my siblings and my friends have been there every step of the way, encouraging me to share with my peers and other Swazi men. I want men to think about their future."



Dlamini said women should also be informed about the benefits of male circumcision so they could encourage their partners, friends and male relatives to follow suit.



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