'Infant circumcision more favourable'

HARARE - Zimbabwe's HIV activists are mooting the introduction of early infant circumcision following an unsatisfactory turnout by adult men.

The activists are lobbying for the introduction of infant circumcision which they hope will help the country achieve set targets.

Webster Mavhu, a representative for the Centre for Sexual Health and HIV/Aids Research Zimbabwe (CeSHHAR Zimbabwe), said pilot implementation of early infant male circumcision looked more favourable than the adult male circumcision.

“Early infant male circumcision will run in parallel with Voluntary Medical Male Circumcision scale up in 2014,” Mavhu said.

“And it has more favourable advantages than adult circumcision. There is fast healing which takes up to seven to 10 days. And fortunately there is no risk of sex before healing,” he told a Zimbabwe Medical Association Congress held in Victoria Falls recently.

Male circumcision is the surgical removal of the foreskin from the male organ.

In a typical procedure, the foreskin is opened and then separated from the glans after inspection, according to World Health Organisation (WHO).

Health experts believe more men can be reached if infant male circumcision is introduced in local hospitals as opposed to adult male circumcision.

At least 150 000 men have been circumcised since 2009.

Mavhu said the low uptake is also being triggered by the procedure’s healing process which takes up to six weeks thereby affecting productivity, contrary to infant circumcision which is a virtually bloodless, cost effective, with no sutures (seams used in the surgery).

“There is no loss of time from school or work and by the time an adult decides, he may be infected,” Mavhu said.

“It is likely to be much more cost effective than adult circumcision, cost-saving even though benefits will take longer to realise. The impact of infant circumcision on HIV incidence reduction can be felt in 15 years.”

He said legal issues tied to circumcising infants may prove to be a hindrance.

Some experts say the procedure is risky and may result in unwarranted complications and others question ethics of removing healthy tissue from someone who is unable to consent.

WHO recommends that infant circumcision should be a component of prevention campaigns since infant circumcision is less complicated and risky procedure than circumcision performed in young boys, adolescents or adults and countries should consider how to promote neonatal circumcision in a safe, culturally acceptable and sustainable manner.

A local paediatrician who spoke on condition of anonymity said evaluation of current evidence indicates the health benefits of new-born male circumcision outweigh the risks and the procedure’s benefits justify access to this procedure for families who choose it.

According to the local expert it reduces risk of urinary tract infections, risk of phimosis, balanitis and there is immediate hygiene.

“Later in life it reduces transmission of HIV, risk of cancer of the penis and cervical cancer for female partner,” said the local expert.

According to the study done by CeSHHAR in 2010, acceptability rate of infant circumcision is high and participants of the study are more concerned with safety and the disposal of the discarded foreskin after procedure.

Shangaan men strongly opposed infant circumcision arguing it separates circumcision from adolescent initiation and allows mothers to nurse circumcision wounds, which is taboo in their culture.

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