South Africa Is Seen to Lag in HIV Fight

At a French-financed clinic in Orange Farm, South Africa, thousands of young men are flocking to be circumcised. The surgical procedure can reduce the chance of female-to-male HIV transmission by up to 60 percent, and two years ago the World Health Organization recommended it especially for countries facing generalized epidemics. Some African governments are actively supporting male circumcision campaigns, but South Africa's is not among them.

Even so, demand for the free surgery at the Orange Farm clinic has surged. "I've done 53 in a seven-hour day, me, myself, personally," said Dr. Dino Rech, who helped design the clinic, which has seven closely spaced surgical tables set up for assembly-line efficiency. Most prospective patients had heard that circumcision was protective against HIV. In addition, some had heard from recently circumcised friends that it made sex better. "'You last longer,'" some friends had told them. "'Your lovers think you're cleaner and more exciting in bed.'"

Over the past year, Botswana has trained medical teams to perform circumcisions in all public hospitals and hopes to reach 80 percent of males by 2016. The government supports public awareness campaigns on radio and television, and billboards feature a national youth soccer team celebrity.

"Anything that could help save lives needs to be tried," said Prime Minister Raila Odinga, a circumcised member of the Luo tribe. While the Luo do not generally circumcise males, Odinga has advocated the procedure and encouraged tribal elders' support.

In South Africa, Zulus have not typically circumcised males since the early 19th century, when the practice ended during prolonged warfare, said Daniel Halperin, an epidemiologist and medical anthropologist at Harvard University.

South Africa's Department of Health is now devising a policy on male circumcision and will be inviting discussion by the end of the month, said Dr. Yogan Pillay, a senior department official.

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