Ephraim Keoreng
3 September 2008
Male circumcision is essential in preventing the spread of HIV infection.
Director of the department of HIV prevention and care, Dr Khumo Seipone said that Botswana needs to implement safe male circumcision as an additional prevention intervention to curb high HIV prevalence, which stands at 17.1 percent for people aged 18 and above.
She said that research findings in countries like South Africa, Kenya and Uganda have shown that male circumcision is efficacious in reducing HIV infection hence the need for Botswana to scale up this component of HIV prevention and develop national policies, strategies and implementation plans, she said, also adding that in Botswana there is strong political will and support for circumcision in government and development partners.
There is also high acceptance of male circumcision in the population, existence of good infrastructure and health systems that could enable scaling up of male circumcision services.
All hospitals are already performing circumcision albeit at a small scale and there is availability of programs at facility and community levels, she said.
She said that the male circumcision strategy has its own challenges, some of which include making sure the intervention does not compromise human rights. There should also be availability of adequate, skilled, motivated doctors and nurses capable of doing high quality MCs.
Ensuring access to the hard to reach populations, ensuring a transparent, coordinated and collaborated effort from all partners and reducing stigma associated with HIV testing and male circumcision status,she said.
She said that male circumcision does not provide complete protection against HIV and that it should never replace other known methods of HIV prevention and should always be considered part of a comprehensive HIV prevention package, which includes promoting correct and consistent use of male and female condoms; providing HIV testing and counseling services and providing services for the treatment of sexually transmitted infections, she said.
She said that scaling up access to male circumcision services shall be promoted as a priority for adolescents. Neonatal circumcision, which is a less complicated and risky procedure will also be promoted. Safe circumcision, she said, shall be performed in a safe, culturally acceptable and sustainable manner.
The service, Seipone disclosed, will be monitored and evaluated for possible untoward effects, such as increases in unsafe and unprotected sex and increases in sexual violence.
Male circumcision services shall not be delivered in isolation, but as part of a recommended minimum package which includes information about the risks and benefits of the procedure, counseling about the need to adopt and maintain safer sex practices, access to HIV testing, condom promotion and provision and the management of sexually transmitted infections,she said.
Promoting circumcision for HIV positive men is not recommended, she said, adding that if HIV infected men request male circumcision, there should be in depth counselling on the known risks and benefits of doing it.
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