Rwanda: Circumcision Drive Worries AIDS Workers

Rwanda’s government this month launched a drive to encourage men to undergo circumcision, a response to the nation’s rising HIV prevalence rate and to research showing the operation can reduce the likelihood of female-to-male HIV transmission. Some experts, however, worry that the plan could backfire if men mistakenly believe the procedure eliminates the need to use condoms to prevent HIV infection.

“Most of the difficulties relate to convincing men that circumcision does not exclude the use of condoms during sex,” said Cyriaque Twagirumukiza, a general practitioner in Kigali, the capital.

Several studies have indicated male circumcision reduces a man’s chances of contracting HIV from a female by more than 50 percent. One, set in South Africa and funded by the French National Agency for Research on AIDS, suggesting a minimum risk reduction of 60 percent.

The World Health Organization and UNAIDS last year produced a report that acknowledged this positive development but also emphasized the importance of additional preventive measures.

“It is critical ... to ensure that clear and correct information on the continuing need for other HIV prevention measures is also provided,” the agencies said. “Communities, and particularly men opting for the procedure and their partners, require careful and balanced information and education materials that underline that male circumcision ... is not a ‘magic bullet’ for HIV prevention but is complementary to other ways of reducing HIV infection.”

Nevertheless in Rwanda, where HIV prevalence has climbed from 3 percent to 3.6 percent in the past year, the government is advancing the program, and the health ministry has begun to provide all medical centers with the equipment needed to safely perform the operation.

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