THE debate on whether to include male circumcision in the comprehensive HIV prevention package continues to top agendas around the world.
Scientists, Aids and human rights activists all agree that male circumcision reduces the risk of contracting HIV in heterosexual men by more than 50percent - if done correctly. But the main issue is at what age the procedure should be done.
Many have suggested that it should be in infancy, but the Children's Act of 2005 does not allow it. The Act prohibits circumcision of males under 16. It only exempts the procedure when performed in accordance with religious practices or for medical reasons.
At present government and other stakeholders are working on ethical issues around this policy. The draft is expected to be finalised later this year.
Mark Heywood, deputy chairperson of the SA National Aids Council, said yesterday: "Though the Children's Act says no child under 16 should be circumcised without a medical or religious reason, we feel that it should be done because it is in the best interest of the child.
"The Constitution does provide for a parent or guardian to decide for a child for medical reasons or if it's in their best interest. In the case of male circumcision it is. We recommend that children under 16 should only be circumcised after proper counselling and with their consent. We are calling on the government to speedily include it in the National Strategic Plan," Heywood added.
While local scientists and civil society are for the inclusion of male circumcision in the HIV prevention package, some Australian researchers are against it. They say there is no evidence that infant circumcision will reduce the risk of sexually transmitted diseases. They further warn that the procedure will have significant psychological harm on males circumcised at infancy.
Caryn Perera, a researcher at the Royal Australian College of Surgeons, wrote in her review in the Annals of Family Medicine: "Strong evidence suggests circumcision can prevent HIV in sub-Saharan African men.
"These findings remain uncertain in men residing in other countries. The role of adult nontherapeutic male circumcision in preventing sexually transmitted infections remains unclear. Current evidence fails to recommend widespread neonatal circumcision for these purposes," she wrote.
"Neonatal circumcision may cause significant anger or feeling incomplete, hurt, frustration, abnormal or feeling ofviolation."