Male circumcision in africa pdf latitude

Geographic coverage of male circumcision in western kenya. In order to better protect female children from the serious and longterm harms of some types of nontherapeutic fga, we must adopt a more. The circumcision rituals are slowly dying out and are being replaced with more modern techniques of circumcision. Male and female circumcision in africa from a regional to. We trained four machinelearning algorithms and selected the best based. Here we focus on the lesotho epidemic, which has received little attention. Changing spatial patterns and increasing rurality of hiv. Overall, male circumcision lowered the risk of hiv infection by about 60 percent. Madagascar, ethiopia, angola, democratic republic of congo and nigeria have the highest rate 90% of male circumcision in africa. Sexuality, africa, historymarc epprechtsexuality, africa. Financing voluntary medical male circumcision through.

Traditional male circumcision has an increased risk for complications that include sepsis, genital mutilation, gangrenous penis. The aap maintainsas previously asserted in its 1999 policy statement97that the health benefits of circumcision are not great enough to recommend routine circumcision of all male. Since the uncircumcised are viewed as children, in their eyes it would be the equivalent of having a seven year old become president of the united states. Thesis, department of anthropology and sociology a significant portion of south africas indigenous population has. Modeling the populationlevel effects of male circumcision as. Angloamerican law historically has been slow to recognize the natural legal rights of children. Machine learning to identify sociobehavioural predictors of. A mass campaign of medical male circumcision mmc is being rolled out in many african countries that are hardhit by hivaids, in an effort to reduce new infections. This guideline has been adapted from the whounaidsjhpiego manual for male circumcision under local anaesthesia to support the south african national.

After stratifying the countries by religious groups, each categorical increase of male circumcision prevalence was associated with a 3. S center for disease control revises circumcision strategy by jack jiri hararezimeyethe us u. Male circumcision as strategy for hiv prevention and sexually. Strengthening health outcomes through the private sector project, abt. The trial in orange farm, south africa enrolled 3274 uncircumcised, hivnegative. Followup research in kenya found that this protective effect of male circumcision was sustained over 42 months, reducing mens chances of. Male circumcision device methods recommended by the world health organization see box 9.

A greek papyrus in the british museum, dated 163 b. We examine those cost drivers here, and estimate the potential efficiency gains through an econometric model. Spatial modelling and mapping of female genital mutilation in. Here we will be concerned with the continuous area of central.

National policies of male circumcision are moving ahead in some areas of subsaharan africa, however, despite the fear of risk disinhibition. New adult hiv infections for 14 countries by scenario 0. Although infancy is the ideal time for a circumcision, many adult men and teens seek circumcision for medical, health, sexual, cultural, religious or cosmetic reasons. The measure demographic and health survey dhs project is an ongoing collaboration between the united states agency for international development and countryspecific agencies to conduct nationally representative household sample surveys with coverage of a range of population health indicators in low and middleincome countries lmics. According to the united nations joint programme on hivaids, the prevalence of male circumcision in the seven countries gallup surveyed is low, ranging from 2% in burundi to 35% in south africa. Prevalence and acceptability of male circumcision in south. In western and northern parts of africa it is mainly performed for religious reasons, whereas in southern parts of africa it rarely performed in neonates, instead being a rite of passage into manhood. Within africa, male circumcision is widely practiced and almost universal in the north and west africa. Cape town the us government will give south africa r100million to expand its medical male circumcision programme, us global aids coordinator, ambassodor eric goos by announced yesterday. Scientificstudies have shown that mmc can cut the risk of a man contracting hiv from vaginal sex.

Compelling experimental evidence has shown that male circumcision reduces the risk of heterosexually acquired hiv infection in men. Actually, research shows that women are 50% more likely to acquire hiv from a. As reported by sunday times news south africa on november 29th, a jewish religious court decided that a johannesburg mohel will not be allowed to perform circumcision again, as a consequence of a botched circumcision performed last year. Financing voluntary medical male circumcision through private medical aid schemes in namibia. Methods and findings we examined the main cost drivers i. Men living with hiv should know that getting circumcised has benefits for them too. More than 16 000 men have so far been circumcised in namibia as part of a voluntary medical male circumcision programme. The manual points out that countries in subsaharan. Circumcision is prevalent among 92% of men in north africa and around 62% in subsaharan africa. Traditional male circumcision in eastern and southern africa.

Africa, indicated that circumcision of heterosexual men could reduce the risk of hiv infection by to 60 percent. Asia, middle east, and north africa, and nonmuslim male contribute only about % w ho, 2007. Page 4 of 264 foreword the lesotho national aids commission nac is a statutory body established by the parliament of the government of lesotho in terms of act no. As with male circumcision it is believed female circumcision was performed to mark class distinction in egypt. Many men have doubts or questions about who can go for circumcision and. Prepex is a method of voluntary medical male circumcision vmmc that can be administered by a nurse in a clean but not necessarily. Background as voluntary medical male circumcision vmmc programs scale up, there is a pressing need for information about the important cost drivers, and potential efficiency gains. We discuss the implications of our results for both the expansion of treatment programs and for.

The nigerian feminist and literary critic, molara ogundipe leslie, in her provocative and insightful text, recreating ourselves. Male circumcision is one of the most commonly performed procedures in africa, with a wide variation between the different regions on the. Male circumcision is common in many african countries and is almost universal in north africa and most of west africa. Circumcision amongst the xhosa people of south africa represents a rite of passage to manhood.

You may search the entire site, including these resources, by adding key words in the search box located in the upper right corner of the website. Voluntary medical male circumcision vmmc reduces the risk of hiv acquisition in men by. There is a need for high yield hiv testing strategies to reach epidemic control. For some time, programs like pepfar presidents emergency plan for aids relief united states have been trying to sell circumcision as beneficial to women. Male circumcision and risk of hiv infection in subsaharan.

Frisch and earp, opponents of male circumcision, have criticized draft recommendations from the cdc that advocate counseling men and parents of newborn boys in the united states about the benefits. We determined the withincountry heterogeneity in the severity of the epidemic, and identified the risk factors for hiv infection. Of current concern is a report by the tasmanian law reform institute tlri recommending that nontherapeutic circumcision be prohibited, with parents and doctors risking criminal sanctions except where the parents have strong religious and ethnic ties to circumcision. Complications of traditional circumcision amongst young. Male circumcision in zambia in zambia, circumcision is traditionally practiced on a large scale only in northwestern province, an area with one of the lowest hiv rates in zambia.

Botched circumcisions becoming health crisis in south africa. The global spread of islam from the 7th century ad necessitated,, knowledge, attitudes and practices of men towards voluntary male medical circumcision. Current drivers and geographic patterns of hiv in lesotho. In the united states, the procedure is commonly performed during the newborn period. Along with many strategies health professionals employ to stem the rate of hivaids, male circumcision has proven to reduce transmission among men. Despite 30 years of advocacy, the prevalence of nontherapeutic female genital alteration fga in minors is stable in many countries. Many countries in subsaharan africa have begun a rapid scaleup vmmc in high hiv prevalence areas where circumcision coverage is low. In the absence of definitive legislation or court rulings regarding the lawfulness of nontherapeutic circumcision of male children within united states law, there is some latitude for different opinions regarding its lawfulness. Get a free and safe circumcision in tshwane rorisang kgosana kagiso modupe, his wife, liza, and residents walk through katlehong before he is circumcised as part of the campaign. Traditional circumcision during manhood initiation rituals. Mapping the spatial variability of hiv infection in sub.

The xhosa tribe in south africa have riteofpassage ritual circumcision into manhood, called ukwaluka in this ritual young men around 18 years of age are circumcised by a traditional practitioner called an incibi during the 10 day recovery period they are mentored by older male caregivers ikhankatha about the secret codes, practices and responsibilities of being a xhosa. Male circumcision rates have a large negative effect on hiv prevalence. The distribution of circumcision and initiation rites throughout africa, and the frequent resemblance between details of ceremonial procedure in areas thousands. South african national guidelines for medical male circumcision. This study aimed at detecting clustering of fgmc in kenya, and identifying those areas within the country where women still intend to continue the practice. During that circumcision, the penis of the baby was partially amputated. An appraisal of current instrumentation 321 view is that, unless or until proof positive e merge s to the effect that a high style confers as. On the contrary, male circumcision is less common in south africa sa where the national hiv prevalence and male circumcision in sa is 18. Cost drivers for voluntary medical male circumcision using. Africa where mc is common 80% generally have an hiv prevalence well below those of countries where. Background evidence from biological, epidemiological, and controlled intervention studies has demonstrated that male circumcision mc protects males from hiv infection, and mc is now advocated as a publichealth intervention against hiv. Color white black red green blue yellow magenta cyan transparency opaque semitransparent. Zambia cumulatively performed over 250,000 male circumcisions by september 2012, and there are plans to conduct 1. In subsaharan africa, where most studies have been done, male circumcision is statistically associated with a reduced rate of hiv infection.

Condom avoidance and determinants of demand for male. I also show that certain forms of male circumcision or male. Boundaries of the roman province syria palaestina, where dashed green line shows the boundary between byzantine palaestina prima later jund filastin and palaestina secunda later jund alurdunn, as well as palaestina salutaris later jebel ettih and the jifar borders of mandatory palestine borders of the palestinian territories west bank and gaza strip which are claimed by the state of. Maps of trucking and trade routes, male circumcision and hiv prevalence, and population mobility in urban areas have shown that geographic factors are important in understanding the risk of hiv infection. Kenyans wondered what would happen if an uncircumcised male won the election. The second part of chapter 1 will elaborate on the origins and reasons for male and infant circumcision and why it. Pdf female genital mutilation and male circumcision. Regional variation in male hiv rates is also strongly correlated with male circumcision rates, which is a cultural initiation ritual among many ethnicities in subsaharan africa. Center for disease control and prevention in zimbabwe says they are going back to the drawing board and map ways of convincing zimbabwean males to get circumcised. Aug 22, 2017 furthermore, the spatial distribution of male circumcision along with its spatial association with hiv infection has supported the implementation of interventions such as voluntary medical male. These tendencies are demonstrated in hundreds of accounts in many different colonial languages, ably analyzed in rudi c. The circumcision campaign promoters have been using women to influence men through means of coercion to go get circumcised. While this degree of polygyny is not extreme in crosscultural perspective 1,3, it creates a pool of 40 per cent of the male population who are shut out of the marriage market. Geographic distribution female circumcision is practiced across africa in a broad triangular eastwest band stretching from senegal in the west to egypt in the northeast and tanzania in the southeast figure 1.

Drs tobian and gray1 highlight the medical benefits of male circumcision, especially protection against infection with the sexually transmitted viral pathogens hiv, herpes simplex. Vocal protests from jewish and muslim groups characterized the courts opinion as an unprecedented intrusion of the right to selfdetermination of religious communities, and prompted the german government to pass legislation allowing ritual male circumcision when performed by a medical professional. We note that clinical trials in other parts of africa kenya, south africa and uganda have shown that medical circumcision protects against hiv infection 1012. Institute for social medicine, epidemiology and health economics, charite university medical centre, berlin, germany. There is compelling evidence that medical male circumcision partially reduces new hiv infections in men and consequently the scalingup of male circumcision in several subsaharan african countries, including south africa, has been recommended who, 2007a, 2007b. Following randomized controlled trials rcts in south africa, kenya, and uganda that demonstrated clinical efficacy of mc in preventing hiv transmission, the world health organization who recommended that promoting male circumcision be adopted as an antihiv strategy, while adding caveats about providing information, considering womens. The igala igara people are largely agrarian and semifishery and yoruboidspeaking people located at one of the natural crossroads in nigerian geography east of river niger, occupying the nigerbenue confluence and and astride the niger in lokoja, kogi state of nigeria. Should the law fix an age of consent for male circumcision. Mc provides direct protection only to men, but is expected to provide indirect protection to women at risk of acquiring hiv from heterosexual transmission.

Africa, has an area of about 2,800,000 square miles south of off that with its greatest depth hitherto 3,250 fathoms presenting a general depth of over 2,200 fathoms mediterranean sea. We have also identified the risk factors that are driving the epidemic and determined whether male circumcision has reduced the risk of acquiring hiv. To be supplied and extends from the atlantic coast inland up to about latitude 7 6. Nov 15, 2008 as with male circumcision it is believed female circumcision was performed to mark class distinction in egypt. Female circumcision in africa 97 northern sudan area. Taba proposes that female circumcision was transported from egypt to the sudan and the horn of africa in the fifth century ce with the migration of the population cited in raswork, 1997, p. The most severe hiv epidemics worldwide occur in lesotho, botswana and swaziland. Origins of ukwaluka xhosa tribe south africa circumcision. Male circumcision efforts lag in africa despite evidence of dramatic impact in preventing hiv date. The ewe speaking people of west africa inhabit the areas between the river volta in modern ghana and the river mono on the western borders of the ancient kingdom of benin dahomey see map 1. African women and critical transformations awp, 1994, wonders at the growing popularity of narratives of victimhood about african women, in euroamerican.

Resource library clearinghouse on male circumcision. Recent attempts in the usa and europe to ban the circumcision of male children have been unsuccessful. Male circumcision, religion, and infectious diseases. In a multivariate model, percent of the population christian and male circumcision, but not percent of the population muslim, remained independently associated with cervical cancer incidence table 3. Male circumcision is almost a universal practice in west and north africa who, 2007. Circumcision is a simple surgical procedure that removes the foreskin a sleeve of skin covering the tip of the penis. The problem is most severe in the eastern cape province, where nearly 500 young men have died in circumcision rituals since 2006, including 83 last year, according to the provincial health department. Male and female circumcision in africa 1183 among the lobi of northwest ghana where only females were reported to be circumcised, but this situation proved to be unstable and female circum cision has declined steeply knudsen, 1994, p. Oct 16, 20 we have also identified the risk factors that are driving the epidemic and determined whether male circumcision has reduced the risk of acquiring hiv. Male circumcision and hiv example mollify page unaids. Mar 25, 2014 female genital mutilationcutting fgmc is still prevalent in several communities in kenya and other areas in africa, as well as being practiced by some migrants from african countries living in other parts of the world.

Herodotus, the greek historian, found the egyptians practicing male and female circumcision when he visited their country around the middle of the fifth century b. A random effects metaanalysis was used to calculate a pooled relative risk rr and 95% confidence interval ci for all studies combined, and stratified by type of study population. Medical male circumcision mmc is a safe and effective way to bring down your risk of hiv infection. Aspects of male circumcision in sub equatorial african. Each tribe manages its own affairs but there are considerable differences between the tribes in botswana and those in south africa. We aimed to predict the hiv status of individuals based on sociobehavioural characteristics. Box 1 randomized controlled trials to examine the impact of male circumcision on hiv. A dutch doctor in south africa has published graphic images of penises mutilated during botched circumcision ceremonies, angering community leaders who accuse him of meddling in their culture dr. If successful, south africa would avert more than 1. Recommendation by a law body to ban infant male circumcision. In 2002, a national study in south africa showed that 35% of men were. While male circumcision has been linked to islam in this context, we report that the male circumcision effect is robust to controlling for the christian population share while the correlation of hiv prevalence and the muslim population share is not. It is one of the most common procedures in the world.

The article states that no details were revealed of why this. Male circumcision is one of the oldest and most common surgical procedures worldwide, and is undertaken for many reasons. Additionally, the 2009 text print media reporting of male circumcision for preventing hiv infection in subsaharan africa concentrates its efforts on the merits of circumcision in, obviously, subsaharan africa. Accounts of serious complications or adverse events after adolescent and adult circumcision in traditional settings in africa are legion. Research article open access current drivers and geographic. Again, it would be redundant for the text to make the qualifier in highrisk areas or in subsaharan africa every sentence as i. Despite continuous viral circulation in the country since at least the 1950 s, and evidence of kinshasa as the epicenter of the epidemic as early as the 1920s, the drc has one of the lowest hiv prevalences in subsaharan africa, estimated at 1. Educational efforts have minimally changed the prevalence of this procedure in regions where it has been widely practiced. South african traditional leaders attack graphic male. Further analyses were conducted among those studies that adjusted for.

Get a free and safe circumcision in tshwane the citizen. To even enter the marriage market, a man has to be in the top 60 per cent of male status. During the apartheid years, south african tswana tribes lived under. As a result, most infections would not begin to be averted from newborn male circumcision until well after 2025.

The first part of chapter 1 will focus on virginity testing, how and where it is practiced, and why it has the potential to be harmful. Conversely, in egypt it is often termed sudanese circumcision. We also determined whether circumcised men in lesotho have had a decreased risk of hiv infection in. Male circumcision violates a childs right to bodily integrity, not to mention numerous civil and criminal laws. Circumcision has a wide variety of complications which include death. This attentiongetting assertion quickly resulted in action by who and the united nations aids advo cacy organization, unaids, both of which recommended expanding programs of male circumcision in subsaharan africa, where hiv rates. In line with the benefits of male circumcision, recently, populationbased data from orange farm in sa have shown lower hiv prevalence and incidence among circumcised men compared. Male circumcision consists of the surgical removal of some, or all, of the foreskin or prepuce from the penis. In 2007, the american academy of pediatrics aap convened a multidisciplinary workgroup of aap members and other stakeholders to evaluate the.

Every circumcision season there are articles in national and local newspapers depicting in words and pictures cases of advanced infection, severe loss of blood, mutilation, and even deaths due to events attributable to male. However, in eastern africa male circumcision rates vary, ranging from 15% in burundi and rwanda, to 84% in kenya, and 93% in ethiopia who, 2007. Africa, botswana, hiv, hiv counseling and testing, male circumcision, medical aid, namibia, south africa recommended citation. Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. On the other hand, in southern africa male circumcision is a rare practice. These factors that increase the risk of hiv infection have been. Maletomale sexual behaviour outside the west and the ethnographic imagination, 17501918 new york, 1995. Learning more about the benefits and disadvantages of circumcision can help you make the call to get circumcised. We analysed over 3,200 variables from the most recent demographic health survey from 10 countries in east and southern africa. Belief in male circumcision varies in subsaharan africa. The perceptions on male circumcision as a preventive.