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Circumcision
message could confuse gay community in Senegal
09 August 2007- Experts are
warning Senegalese men who have sex with men not to get caught up in the
hype about male circumcision after recent research indicated that the
procedure could offer some protection against HIV, and are urging them
to keep using other means of protection.
In 2006, the results of three
studies, one each in South Africa, Kenya and Uganda, showed that the
risk of HIV infection was up to 60 percent lower among circumcised men.
However, these studies were specific to heterosexual interaction.
The HIV prevalence among men who
have sex with men (MSM) in Senegal is an estimated 21.5 percent,
according to the French Institute for Applied Medicine and Epidemiology
(IMEA), compared to a national average of 0.7 percent. AIDS campaigners
worry that the preliminary data on male circumcision could lead to
reckless sex and an even higher HIV prevalence.
In a 2003 study on stigma, violence
and HIV among MSM by Dr Cheikh Niang of the Cheikh Anta Diop University
in Dakar, the Senegalese capital, only 23 percent of MSM said they had
used a condom during their last sexual encounter.
"Within Senegal's cultural context
... where homosexuality remains a taboo subject, we do not want to
encourage people to hide behind the idea that circumcision completely
prevents the transmission of HIV," Jean-Louis Rodriguez, former
executive secretary of And Ligeey, a Senegalese association working to
protect the rights of gay men, told IRIN/PlusNews.
He said the hidden nature of
homosexuality in Senegal meant gay men often married or had girlfriends
in order to fit into society, but still engaged in clandestine
homosexual activity, putting many people at risk. In the IMEA study, 94
percent of participants also had sexual relations with women.
The results of observational
research, published in the Journal of Infectious Diseases in 1993,
suggested that the risk of circumcised homosexuals contracting HIV
during sex could be halved; another study in 2005 in the United States
reached the same conclusion.
However, neither of these was as
extensive as the three African studies that prompted the United Nations
World Health Organization (WHO) to recommend male circumcision as a tool
in the fight against the AIDS pandemic.
"We know nothing; [these] are
observational studies; therefore, they prove nothing," Bertran Auvert,
one of the authors of the South African study, said in an interview
published on a gay rights website called 'The Warning'. "We can merely
suppose that there is a certain level of protection."
The only thing the medical
profession is sure of is that MSM run a considerable risk of HIV
infection, especially since intercourse is often unprotected.
Vigilance in prevention
must be maintained
"Prevention must always be
targeted, so that the message can be better understood and conveyed in
the correct manner. When I hear all the media hype about circumcision, I
get scared that people will get confused," said Rodriguez.
"We have not yet worked on a
specific statement to raise awareness, even if it were merely to tell
people that condoms are the only thing that can offer protection."
Khoudia Sow, the HIV/AIDS focal
point for the WHO in Senegal, commented that "It is certainly not a
question of revising all our prevention techniques; circumcision could
play a part in the range of existing measures, but in no instance would
it substitute them."
The university's Dr Niang agreed. "MSM
have to deal with many situations where they are excluded. Their lives
are unstable, they are rejected by society and the health services, they
do not have much control over negotiating their sexual relations, and
drug use can also be an issue," he said. "These factors increase the
risk of HIV infection a great deal more than whether or not they are
circumcised."
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