Kenyan Government Adopts Male Circumcision as a Standard HIV Prevention Strategy

The Kenyan government has issued a new policy to adopt male circumcision as a standard HIV prevention strategy, Kenya's Nation reports. The Policy on Male Circumcision in Kenya 2008 calls for the procedure to be provided to all willing males. The decision to adopt circumcision as an HIV intervention follows studies showing that male circumcision can significantly lower risk for HIV, the Nation reports.

According to the policy, male circumcision will become the fourth part of the ABC HIV prevention approach -- which stands for abstinence, be faithful, use condoms. The new approach will be ABCC, with the last C representing circumcision. The proposed policy notes that circumcision will not replace current effective HIV prevention methods and that it should be considered as part of a comprehensive prevention package, the Nation reports.

Under the policy, the government will provide training on circumcision to health workers. The policy says health facilities must "ensure that male circumcision is performed by well-trained practitioners in antiseptic settings under conditions of informed consent, confidentiality, risk-reduction counseling and safety."

According to the Nation, facilities from the dispensary to the district hospital levels are to be strengthened to handle the increased demand for the procedure. In addition, those implementing the policy will be required to establish laws and supervisory mechanisms that make circumcision services safely accessible without being discriminatory, the Nation reports.

According to the Nation, the policy calls on the Ministry of Health to "strengthen health systems to ensure that male circumcision programs do not interrupt or divert resources from other primary health care services." According to the Nation, the health ministry will have to integrate the management of reproductive, sexual health and HIV prevention programs to provide male circumcision services.

In addition, a male circumcision task force is expected to help guide the circumcision efforts. The proposed task force will help:

• Advise the health ministry on development programs for expanding quality male circumcision services;
  
  
• Provide professional, technical and administrative assistance during the effort;
  
  
• Ensure accurate and appropriate dissemination of information; and
  
  
• Promote male circumcision within the context of the general enhancement of health care services.

Ruth Njeri, an HIV/AIDS advocate, said she fears the new policy might make circumcised men have unprotected sex and think they are safe. "Men who have been using condoms or those who have been faithful to their spouses will now opt for unprotected sex," Njeri said. Alloys Orago, director of the National AIDS Control Council, said, "What we are trying to pass across is that a circumcised man who either uses a condom or is faithful to his partner has a reduced risk of HIV infection" (Okwemba, Nation, 4/10).

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