
What is Male Circumcision?
Male circumcision is the surgical removal of all or part of the foreskin of the penis. The government of Kenya is encouraging adult men who are uncircumcised to do so as a way of reducing the risk of HIV infection.
Male Circumcision Campaign in Kenya
The Ministry of Medical Services is targeting to circumcise an estimated one million men in the next four years in the ongoing program on male circumcision for HIV prevention.
The program aims to reduce the number of new HIV infections in the country by improving and expanding the provision of safe and voluntary male circumcision services. It was launched 3 years ago and has since seen 90,000 men in Nyanza, where the project began undergo circumcision.
During the third stakeholder’s meeting on voluntary medical male circumcision at Kisumu’s Tom Mboya Labour College, the Medical Services Minister Prof. Anyang Nyongo said public health experts have advised on the need to carry out safe, medical circumcision as a new intervention to prevent HIV alongside the other practiced methods which include abstinence, being faithful and correct and consistent use of condom.
The minister observed that the strategy was embraced after three clinical trials conducted on men showed that being circumcised drastically reduced the risk of HIV acquisition by men during penile-vaginal sex. The studies conducted in Kenya, Uganda and South Africa showed that male circumcision lowered the risk of HIV infection by about 60 %.
Out of the total number of men expected to be circumcised in the country, Nyanza will account for 430,000 men who fall between the ages of 15 to 49 years.
The government chose to first roll out the program in Nyanza province because culturally, most men do not get circumcised. The region was also leading on HIV prevalence which stands at 16 percent, higher than even the national average, according to statistics from the ministry.
The circumcision services are provided free in government health facilities and in various identified outreach centers throughout the country.
How is an uncircumcised man at risk of contracting HIV?
Compared to the external skin surface, the underside of the foreskin has a higher density of Langerhans cells. These are special immunological cells which are prime targets for HIV. The inner surface of the foreskin is also very delicate and during sexual intercourse, it is susceptible to small tears that can allow for easier entry of HIV. The space between the penis glans and the foreskin may also provide a conducive environment for viral survival.
Will circumcision affect penile sensation and sexual function?
Even though the program has received huge support from the local political leaders among the Prime Minister Raila Odinga, the council of community leaders has a few misgivings. Apart from that the practice is against the cultural practices of the community; the biggest fear is that it will reduce men’s sexual potency.
Studies conducted among men after adult circumcision suggest there was none or very little difference in penile sensation or sexual function. In the trials conducted in the 3 African countries, the men acquired the same high level of sexual satisfaction as they did before circumcision.