2015-09-29 Key Correspondents - "Chifamba’s story: “circumcision made me a happy man”"

Cite as: Majaha, D (2015) Chifamba’s story: “circumcision made me a happy man” Key Correspondents Full-text available at http://www.keycorrespondents.org/2015/09/29/chifambas-story-circumcision-made-me-a-happy-man/ Accessed: 29 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2015-09-29-key-correspondents-chifambas.html

Excerpt:

The revised Zimbabwe Policy Guidelines on Voluntary Medical Male Circumcision of 2014 estimated the number of circumcised men to be just 10 per cent. But in January 2015, Zimbabwe launched an ambitious US$100 million male circumcision programme which aims to get 80 per cent of Zimbabwean men (around 2 million men) circumcised voluntarily by 2018.

In order to increase male participation in circumcision, it will be provided alongside other male sexual and reproductive health services. But to achieve these ambitious targets, the government needs to ensure people have access to accurate information. According to the guidelines on male circumcision, “This shall entail broad community engagement, initially to introduce, and later to scale up male circumcision services.”

Zimbabwe has also introduced the non-surgical method of circumcision in some towns and centres. This consists of a device made of a plastic and rubber ring that stops the flow of blood to the part of the foreskin that is to be removed.
...
According to research commissioned by the University of Zimbabwe and Ministry of Health and Child Care, there are various reasons why some men in Zimbabwe shun the procedure. These include fear of poor wound healing and fear of knowing one’s HIV status, which is one of the standard tests done when providing voluntary male circumcision.

Allenah, 27, who grew up in a polygamous family, argues that male circumcision is alien to his culture. “My father was not circumcised but lived a healthy life with his three wives. This is against our culture,” he said.

Eunice, a married woman from Harare, says she is not comfortable with her husband getting circumcised. She is concerned that the idea of “being safe” is likely to influence him to become sexually active outside of the marriage.
...
Other Nathan Mutendi, a university student, believes circumcision is an unnecessary process as it is not as effective as wearing a condom when having sexual intercourse.

“I do not see the reason why I should get circumcised to protect myself from HIV and then later wear a condom which is proven to be more than 99 per cent safe,” says Mutendi.

But, as Dr Makaure explains: “There are incidents in which a condom is worn in a wrong way and, due to friction, breaks down. In such cases, uncircumcised men are at a higher risk than those who are circumcised.”

Archived URL: https://web.archive.org/web/20151029071737/http://www.keycorrespondents.org/2015/09/29/chifambas-story-circumcision-made-me-a-happy-man/

2015-09-28 The Star (Kenya) - "New drive for men, infant circumcision"

Cite as: Matete, F (2015) New drive for men, infant circumcision The Star 28 September 2015 Full-text available at http://www.the-star.co.ke/news/new-drive-men-infant-circumcision Accessed: 29 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2015-09-28-star-kenya-new-drive-for-men.html

THE government has launched the second phase of the drive for voluntary medical circumcision of men and infants.

Representative of the Parliamentary Health Committee chairperson MP Paul Koinange said the drive targets more than one million men and infants below 60 days in the next five years.

He spoke on Friday during the launch of the circumcision strategy and a clinical manual at Tom Mboya Labour College in Kisumu.

Koinange said the government wants to increase the proportion of circumcised boys and men aged between 15 and 49 from 91 per cent to 95 per cent.

He said the drive aims to circumcise at least 40 per cent of infant boys after birth by 2019.

The Health ministry National Strategy 2014-19 says a pilot study in Nyanza to assess safety and acceptability of medical circumcision showed it is safe and accepted.

Koinange said circumcision will be offered in certain health facilities as part of the package of infant care.

Infant circumcision ensures boys grow up with lower HIV-Aids risk.

Archived URL: https://web.archive.org/web/20151029070617/http://www.the-star.co.ke/news/new-drive-men-infant-circumcision

2013-06-24 Uganda Picks - "Mbale Residents Flee Forceful Circumcision"

Excerpt:

If you are an adult male who has been planning to visit Mbale anytime this week, then you might as well postpone your visit unless you want to be circumcised in the streets. The youth in Mbale are on the run following the forceful circumcision campaign that started last week.
The operation is being spearheaded by the Mbale male Bagisu youth against their colleagues that have not been circumcised. Business in the town has been affected as the uncircumcised have begun fleeing lest they be injured and ruthlessly circumcised.

Archived URL: http://www.webcitation.org/6HgAOPB1e

2012-05-10 allAfrica.com - "Kenya: The Cut for Boys to Tame HIV"

Excerpt:

THE Ministry of Public Health and Sanitation will soon introduce circumcision programme for children under the age of 15 to help curb HIV/Aids in the country. Homa Bay branch DASCOP coordinator Alice Nyambai said they hope to introduce the program to children under 15 years, as a way of supplementing the Voluntary Medical Male Circumcision (VMMC) exercise.
Nyambai said that the programme will help in the reduction of HIV/AIDS infections as more males get circumcised in the region despite being more affordable as compared to the VMMC.

 Archived URL: http://www.webcitation.org/68TrTJpmb

2013-07-22 The Star (Kenya) - "Met to get cash, food prizes for circumcision"

Excerpt:

Kenya National Male Circumcision task force and players in the Voluntary Medical Male Circumcision have launched a pilot study to lure men within 24-49 years to circumcision. The  initiative is aimed at circumcising male adults. 
The awareness will start at greater Nyando before being rolled out to other parts of the region. The initiative will also provide food incentives, cash and shopping vouchers to families of those willing to be circumcised to entice more men  to be circumcised.

Archived URL: http://www.webcitation.org/6IMrKH0CD

2012-07-13 The Sunday Mail (Zimbabwe) - "Were we fooled?"

Excerpt:

Dozens of billboards emblazoned with the message “Circumcision — one of the top defenders against HIV and Aids” are now a common sight on major roads in Harare.

Such loud advertisements, alongside an aggressive campaign in newspapers and on air, form part of a multi-million-dollar campaign aimed at encouraging sexually active men to get circumcised as a way of reducing the risk of contracting HIV.

Recently, Members of the House of Assembly and leading celebrities were roped into the campaign to try and encourage more men within the 15 and 49 age group to get circumcised.
...
However, what is clear to many is that circumcised youths have turned to sexually risky behaviour in the false belief that circumcision gives them an “invisible condom”.

Others are of the view that Africa might have been sold a ruse by the WHO in cahoots with Western researchers.

Archived URL: http://www.webcitation.org/6LtwhZhpQ

2013 - Response to “PEPFAR Program Expenditures” [Form Number: DS-4213, OMB Control Number: 1405-0208]

Thank you for the opportunity to provide feedback to “PEPFAR Program Expenditures” [Form Number: DS-4213, OMB Control Number: 1405-0208]. This response document will briefly address concerns about the ethical, legal and methodological flaws with past research informing aspects of present PEPFAR program areas; concerns about adverse consequences of PEPFAR program areas; and concerns about the absence of oversight of the activities of PEPFAR funding recipients.

Ethical, Legal and Methodological Flaws with Past Research informing present PEPFAR Program Areas

In 2011 and 2012, the Department of Health and Human Services Office of Inspector General [OIG] published a series of audit reports revealing that throughout fiscal years 2000-2010, the National Institute of Allergy and Infections Diseases [NIAID], did not comply with the time and amount requirements specified in appropriations statutes, in awarding several federal contracts to commercial partners, committing the federal government to tens of millions of dollars of expenditure ahead of appropriation of funds from Congress (OIG 2011a; OIG 2011b; OIG 2011c; OIG 2011d; OIG 2012a; OIG 2012b). During this time, NIAID also funded and sponsored research conducted abroad, that would be unlikely to receive ethical approval to be conducted in the United States, incorporating the excision of healthy tissue from subjects in the absence of a clear and present immediate medical indication, specifically ClinicalTrials.gov registered trials NCT00059371 and NCT00425984 ['the African circumcision trials'] (NIH 2008; NIH 2007), the methodology, conclusions, ethics and legality of which have been questioned in the professional medical literature (Boyle & Hill 2011; Green et al 2010). In the years following publication of the African circumcision trials, regulatory agencies under the aegis of the Department of Health and Human Services have moved to strengthen protections afforded human research subjects and to increase the rigor with which trials conducted abroad are assessed as a basis for seeking approval of new drugs and medical devices in the U.S. market (FDA 2012; OHRP 2011), although concerns continue to be raised about the capability of National Institutes of Health [NIH] Data and Safety Monitoring Boards to ensure the safety of study subjects and validity and integrity of the data for clinical trials (OIG 2013a).

Adverse Consequences of PEPFAR Program Funding Areas

Despite the concerns identified above, the results of the African circumcision trials continue to be used to justify the en masse circumcision of men in Africa using PEPFAR funds and to justify the circumcision of boys and male infants - both in the United States and abroad - in the absence of clear and present immediate medical indications, and in the latter instance, with the tacit endorsement of U.S. government agencies in receipt of PEPFAR program funding (CDC 2011; Llewellyn 2012). In the wake of PEPFAR funding for mass circumcision programs in Africa, human rights organisations and local media in the region have reported coercion of men and boys to be circumcised (AFP 2012; Ahlberg & Njoroge 2013; Aluru 2013; Amnesty International 2013; Chibaya 2013a; Chibaya 2013b; Chirombo 2013; Dube 2012; Echwala 2013; Handable 2013; Hatyoka 2013; Langa 2012; Layoo 2013; Mbanje 2013; Mhlanga 2012; News24 2013; Ngwega 2012; Okwii 2013; Onyango 2012; Otieno 2013; Towindo 2012) and misdirection of limited medical resources from other priority areas to male circumcision (AHN 2012; Gonzalez 2012; ZimEye 2013).

Absence of Oversight

On the 15 June 2011, the OIG published a report critical of the Centers for Disease Control and Prevention's [CDC's] failure to oversee recipientss use of PEPFAR funds, concluding that the “lack of required documentation demonstrates that CDC has not exercised proper stewardship over Federal PEPFAR funds because it did not consistently follow departmental and other Federal requirements in monitoring PEPFAR recipients” (OIG 2011e). Further investigations by the OIG have also revealed specific failures of the CDC to monitor recipients use of PEPFAR funds in Namibia (OIG 2013c; OIG 2013d) and South Africa (OIG 2013b; OIG 2013e; OIG 2013f; OIG 2013g). In 2013, the OIG also published a report critical of the CDC's failure to oversee use of PEPFAR funds by the Vietnam Administration for HIV/AIDS Control (OIG 2013h), suggesting the possibility that more systemic problems may exist within the CDC, impacting the agency's ability to effectively oversee the activities of grantees in receipt of federal funds, and that this is not specific to difficulty with oversight of grantees in the African region.

Conclusion

Valid concerns exist about the ethical, legal and methodological flaws with past research informing aspects of present PEPFAR program areas; adverse consequences of PEPFAR program areas; and the absence of oversight of the activities of PEPFAR funding recipients. It is therefore imperative that full and complete disclosure and oversight in the proposed information collection activity take precedence over the CDC's and PEPFAR funding recipients' professed concerns for increased regulatory and administrative 'burden'.

References

AFP (2012) US urges circumcision for soldiers to fight HIV in Africa Yahoo! Health http://health.yahoo.net/news/s/afp/us-urges-circumcision-for-soldiers-to-fight-hiv-in-africa Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68Trj7ABp

Ahlberg BM, Njoroge KM (2013) 'Not men enough to rule!': politicization of ethnicities and forcible circumcision of Luo men during the postelection violence in Kenya Ethn Health. 2013 Oct;18(5):454-68. doi: 10.1080/13557858.2013.772326. Epub 2013 Jun 11 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23758644

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Aluru L (2013) Siaya County seeks forced male ‘cut’ law 2 October 2013 Standard Digital News http://www.standardmedia.co.ke/?articleID=2000094743&story_title=Kenya-county-seeks-forced-male-cut-law Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtnVPjiW

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Boyle GJ, Hill G (2011) Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns J Law Med. 2011 Dec;19(2):316-34 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22320006

CDC (2011) Trends in In-Hospital Newborn Male Circumcision - United States 1999-2010 Prepared by Xinjian Zhang, PhD, Sanjyot Shinde, PhD, Peter H Kilmarx, MD, Robert T Chen, MD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Shanna Cox, MSPH, Lee Warner, PhD, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion; Maria Owings, PhD, Div of Healthcare Statistics, National Center for Health Statistics; Charbel El Bcheraoui, PhD, EIS Officer, CDC. Morbidity and Mortality Weekly Report (MMWR) Full-text available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w

Chibaya, M (2013a) Resistance hinders circumcision programme The Standard Full-text available at http://www.thestandard.co.zw/2013/05/19/resistance-hinders-circumcision-programme/ Archived by WebCite at http://www.webcitation.org/6Ltky3cRF

Chibaya, M (2013b) Winky D tackles circumcision controversy New Zimbabwe 21 October 2013 Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtoaHGyi

Chirombo, S (2013) Malawi: Kasungu Registers Low Turnout for Male Circumcision allAfrica.com 5 July 2013 Accessed: 2013-07-08. Archived by WebCite at http://www.webcitation.org/6HxNQ2VYn

Dube, C (2012) F/town adult males spurn circumcision The Monitor 21 May 2012 http://www.mmegi.bw/index.php?sid=1&aid=370&dir=2012/May/Monday21 Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68TqWHbxL

Echwala, E (2013) Zimbabwe's circumcision drive fails to take off IRIN News 9 July 2013 http://www.irinnews.org/report/98379/zimbabwe-s-circumcision-drive-fails-to-take-off Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6Ltn5kJBC

FDA (2012) FDA's HSP/BIMO Initiative Accomplishments: Update May 2012 Food and Drug Administration Full-text available at http://www.fda.gov/ScienceResearch/SpecialTopics/RunningClinicalTrials/ucm305275.htm Accessed: 2012-06-10. Archived by WebCite at http://www.webcitation.org/68JLjWhEP

Gonzalez L L (2012) Africa: Less Global Funds, More Problems allAfrica 10 May 2012 Full-text available at http://allafrica.com/stories/201205110671.html

Green LW, Travis JW, McAllister RG, Peterson KW, Vardanyan AN, Craig A (2010) Male circumcision and HIV prevention insufficient evidence and neglected external validity Am J Prev Med. 2010 Nov;39(5):479-82 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20965388

Handable, N (2013) Zambia: Women Should Encourage Their Partners allAfrica.com http://allafrica.com/stories/201211201412.html Accessed: 2013-12-16. Archived by WebCite at http://www.webcitation.org/6LvIDW2pt

Hatyoka, B (2013) ‘Sensitise subjects on male circumcision’ Times of Zambia 22 May 2013 Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtlPFBWm

Langa, V (2012) 175 MPs to be circumcised News Day 18 May 2012 http://www.newsday.co.zw/article/2012-05-18-175-mps-to-be-circumcised/ Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68Tqz9L2u

Layoo, R (2013) Former inmates decry forced circumcision Daily Monitor http://www.monitor.co.ug/News/National/Former-inmates-decry--forced-circumcision/-/688334/2110502/-/1wm3ydz/-/index.html Accessed: 2013-12-16. Archived by WebCite at http://www.webcitation.org/6Ltvm2Hi9

Llewellyn, E (2012) Infant Circumcision: A Tipping Point for HIV Prevention USAID Frontlines May/June 2012 Full-text available at http://transition.usaid.gov/press/frontlines/fl_may12/FL_may12_U5_SWAZILAND.html Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68U9lv9vt

Mbanje, P (2013) Zimbabwe government takes circumcision into the classroom The Standard http://www.thestandard.co.zw/2013/12/08/zimbabwe-government-takes-circumcision-classroom/ Accessed: 2013-12-16. Archived by WebCite at http://www.webcitation.org/6LtvSfy7N

Mhlanga, P (2012) Govt sharpens knives for forced circumcision NewsDay 1 December 2012 Full-text available at http://www.newsday.co.zw/2012/12/01/govt-sharpens-knives-for-forced-circumcision/

News24 (2013) Minister urges MPs to get circumcised News24 website http://www.news24.com/SouthAfrica/Politics/Minister-urges-MPs-to-get-circumcised-20131022 Archived by WebCite at http://www.webcitation.org/6Ltunawpb

NIH (2008) Male Circumcision and HIV Rates in Kenya ClinicalTrials.gov website 28 May 2008 Full-text available at http://www.clinicaltrials.gov/ct2/show/NCT00059371

NIH (2007) Male Circumcision for HIV Prevention in Rakai, Uganda ClinicalTrials.gov website 23 August 2007 Full-text available at http://www.clinicaltrials.gov/ct2/show/NCT00425984

Ngwega, N (2012) Tanzania: Handeni Promotes Male Circumcision to Curb HIV Spread allAfrica.com 11 February 2012 Full-text available at http://allafrica.com/stories/201302110873.html

OHRP (2011) Regulatory Changes in ANPRM Comparison of Existing Rules with Some of the Changes Being Considered Office of Human Research Protections website Full-text available at http://www.hhs.gov/ohrp/humansubjects/anprmchangetable.html Accessed: 2012-01-16. Archived by WebCite at http://www.webcitation.org/64jh4cWek

OIG (2011a) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN266-2006-00015C With NexBio, Inc. (A-03-10-03119) Health and Human Services Office of Inspector General website 21 September 2011 Full-text available at http://oig.hhs.gov/oas/reports/region3/31003119.pdf

OIG (2011b) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN272-2008-00013C with the EMMES Corporation (A-03-10-03115) Health and Human Services Office of Inspector General website 31 October 2011 Full-text available at http://oig.hhs.gov/oas/reports/region3/31003115.pdf

OIG (2011c) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-15416 With the University of California at San Francisco Audit (A-03-10-03120) on the Health and Human Services Office of Inspector General website 10 July 2011 Available at http://oig.hhs.gov/oas/reports/region3/31003120.pdf

OIG (2011d) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-3-0052 With Avecia Biologics Limited (A-03-10-03117) Health and Human Services Office of Inspector General website 21 September 2011 Full-text available at http://oig.hhs.gov/oas/reports/region3/31003117.pdf

OIG (2011e) Review of the Centers for Disease Control and Prevention’s Oversight of the President’s Emergency Plan for AIDS Relief Funds for Fiscal Years 2007 Through 2009 (A-04-10-04006) Health and Human Services Office of Inspector General website 15 June 2011 Full-text available at http://oig.hhs.gov/oas/reports/region4/41004006.pdf

OIG (2012a) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN266-2005-00022C With PPD Development, LP (Audit A-03-10-03118) Health and Human Services Office of Inspector General website 14 September 2012 Full-text available at https://oig.hhs.gov/oas/reports/region3/31003118.pdf

OIG (2012b) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-30068 With PPD Development, LP (Audit A-03-10-03116) Health and Human Services Office of Inspector General website 14 September 2012 Full-text available at https://oig.hhs.gov/oas/reports/region3/31003116.pdf

OIG (2013a) Data and Safety Monitoring Boards in NIH Clinical Trials: Meeting Guidance, But Facing Some Issues (Report OEI-12-11-00070) Health and Human Services Office of Inspector General website 28 June 2013 Full-text available at https://oig.hhs.gov/oei/reports/oei-12-11-00070.pdf

OIG (2013c) The Centers for Disease Control and Prevention's Namibia Office Did Not Always Properly Monitor Recipients' Use of the President's Emergency Plan for AIDS Relief Funds Audit (A-04-12-04020) Health and Human Services Office of Inspector General website 19 November 2012 Full-text available at https://oig.hhs.gov/oas/reports/region4/41204020.pdf

OIG (2013d) The Republic of Namibia, Ministry of Health and Social Services, Did Not Always Manage the President’s Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-04-12-04019) Health and Human Services Office of Inspector General website 19 November 2012 Full-text available at https://oig.hhs.gov/oas/reports/region4/41204019.pdf

OIG (2013b) The Centers for Disease Control and Prevention's South Africa Office Did Not Always Properly Monitor Recipients' Use of the President's Emergency Plan for AIDS Relief Funds (Audit A-04-12-04022) Health and Human Services Office of Inspector General website 12 February 2013 Full-text available at https://oig.hhs.gov/oas/reports/region4/41204022.pdf

OIG (2013e) National Health Laboratory Service Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-05-12-00024) Health and Human Services Office of Inspector General website 15 August 2013 Full-text available at http://oig.hhs.gov/oas/reports/region5/51200024.pdf

OIG (2013f) The South African National Department of Health Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-05-12-00022) Health and Human Services Office of Inspector General website 23 August 2013 Full-text available at http://oig.hhs.gov/oas/reports/region5/51200022.pdf

OIG (2013g) Aurum Institute for Health Research Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-05-12-00021) Health and Human Services Office of Inspector General website 23 August 2013 Full-text available at http://oig.hhs.gov/oas/reports/region5/51200021.pdf

OIG (2013h) The Vietnam Administration for HIV/AIDS Control Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-06-11-00057)  Health and Human Services Office of Inspector General website 10 June 2013 Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-06-10-hhs-oig-vietnam.html

Okwii, E (2013) Mbale Residents Flee Forceful Circumcision Uganda Picks 24 June 2013 Accessed: 2015-10-02. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-06-24-uganda-picks-mbale-residents.html

Onyango, H (2012) Kenya: The Cut for Boys to Tame HIV allAfrica Accessed: 2015-10-02. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2012-05-10-allafricacom-kenya-cut-for.html

Otieno, S (2013) Met to get cash, food prizes for circumcision The Star 22 July 2013 Accessed: 2015-10-02. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-07-22-star-kenya-met-to-get-cash.html

Towindo, L (2012) Were we fooled? The Sunday Mail 13 July 2012  Accessed: 2015-10-01. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2012-07-13-sunday-mail-zimbabwe-were-we.html

ZimEye (2013) Zimbabwe Buys Into Controversial Israeli Style Circumcision ZimEye Accessed: 2015-10-01. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-11-10-zimeye-zimbabwe-buys-into.html

2015-09-25 Kisumu County News (Kenya) - Nascop to launch second national circumcision strategy in Kisumu

Excerpt:

The National Aids and STI Control Programme (Nascop) is set to launch the second edition of the National Voluntary Medical Male Circumcision (VMMC) strategy in Kisumu on Friday.

The second national VMMC Strategy which covers from 2014-2019 will be launched at the Tom Mboya Labour College.

The secretary of the Inter Counties Task Force on VMMC, Isaac Oguma said in a statement that the strategy will guide in the implementation of VMMC activities for a five-year period.
...
 As a result of this program, the national coverage of male circumcision has increased from 85 percent in 2007 to 91 percent in 2012 against a national target of 94%.

In Kisumu County alone, nearly 200,000 males are targeted during the second phase.

URL: http://www.hivisasa.com/kisumu/health/81591

2015-09-21 PLoS One. - "Acceptability of Male Circumcision among College Students in Medical Universities in Western China: A Cross-Sectional Study"

Excerpt:

Author information

1 Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China.
2 Department of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, Georgia, 30310, United States of America.
3 The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China.
4 School of Public Health, Xinjiang Medical University, Xinjiang, 830011, China.
5 School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
6 National Center for STD Control, Chinese Center for Disease Control and Prevention, Nanjing, 210042, China.
7 State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, 102206, China.
8 Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China; Guangxi Medical Research Center, Guangxi Medical University, Nanning, Guangxi, 530021, China

Abstract
Background

Male circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore MC’s acceptability and the factors associated with MC among college students in medical universities in western China.
Methods

A cross-sectional study was carried out in three provinces in western China (Guangxi, Chongqing and Xinjiang) to assess the acceptability of MC as well as to discover factors associated with the acceptability among college students in medical universities. A total of 1,790 uncircumcised male students from three medical universities were enrolled in this study. In addition, 150 students who had undergone MC were also enrolled in the survey, and they participated in in-depth interviews.
Results

Of all the uncircumcised participants (n = 1,790), 55.2% (n = 988) were willing to accept MC. Among those who accepted MC, 67.3% thought that MC could improve their sexual partners’ hygiene, 46.3% believed that HIV and sexually transmitted diseases (STDs) could be partially prevented by MC. The multivariable logistic regression indicates that MC’s acceptability was associated with three factors: the redundant foreskin (OR = 10.171, 95% CI = 7.629–13.559), knowing the hazard of having a redundant foreskin (OR = 1.597, 95% CI = 1.097–2.323), and enhancing sexual pleasure (OR = 1.628, 95% CI = 1.312–2.021). The in-depth interviews for subjects who had undergone MC showed that the major reason for having MC was the redundant foreskin (87.3%), followed by the benefits and the fewer complications of having MC done. In addition, most of these participants (65.3%) said that the MC could enhance sexual satisfaction.
Conclusions

MC’s acceptance among college students in medical universities is higher than it is among other populations in western China. An implementation of an MC programme among this population is feasible in the future.

PMID: 26390212

URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135706

2015-09-15 Glob Health Sci Pract. - "Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania"

Excerpt:

Author information

1 Jhpiego, Dar Es Salaam, Tanzania.
2 Jhpiego, Baltimore, MD, USA.
3 Jhpiego, Baltimore, MD, USA.
4 United States Agency for International Development (USAID), Dar Es Salaam, Tanzania.
5 USAID, Washington, DC, USA.
6 Tanzania Ministry of Health and Social Welfare, Dar Es Salaam, Tanzania.

Abstract

Background: Based on the established protective effect of voluntary medical male circumcision (VMMC) in reducing female-to-male HIV transmission, Tanzania's Ministry of Health and Social Welfare (MOHSW) embarked on the scale-up of VMMC services in 2009. The Maternal and Child Health Integrated Project (MCHIP) supported the MOHSW to roll out VMMC services in Iringa and Njombe, 2 regions of Tanzania with among the highest HIV and lowest circumcision prevalence. With ambitious targets of reaching 264,990 males aged 10–34 years with VMMC in 5 years, efficient and innovative program approaches were necessary.

Program Description: Outreach campaigns, in which mobile teams set up temporary services in facilities or non-facility settings, are used to reach lesser-served areas with VMMC. In 2012, MCHIP began using geographic information systems (GIS) to strategically plan the location of outreach campaigns. MCHIP gathered geocoded data on variables such as roads, road conditions, catchment population, staffing, and infrastructure for every health facility in Iringa and Njombe. These data were uploaded to a central database and overlaid with various demographic and service delivery data in order to identify the VMMC needs of the 2 regions.

Findings: MCHIP used the interactive digital maps as decision-making tools to extend mobile VMMC outreach to “the last kilometer.” As of September 2014, the MOHSW with MCHIP support provided VMMC to 267,917 men, 259,144 of whom were men were aged 10–34 years, an achievement of 98% of the target of eligible males in Iringa and Njombe. The project reached substantially more men through rural dispensaries and non-health care facilities each successive year after GIS was introduced in 2012, jumping from 48% of VMMCs performed in rural areas in fiscal year 2011 to 88% in fiscal year 2012 and to 93% by the end of the project in 2014.

Conclusion: GIS was an effective tool for making strategic decisions about where to prioritize VMMC service delivery, particularly for mobile and outreach services. Donors may want to consider funding mapping initiatives that support numerous interventions across implementing partners to spread initial start-up costs.

PMID: 26374807

URL: http://www.ghspjournal.org/content/3/3/503.long

2014-08-18 CDC - "Early Infant Male Circumcision: A Giant Leap toward an HIV-Free Generation in Botswana"

Excerpt:

Baby Tyrone was among the first infants in Botswana circumcised with one of two newly introduced medical devices for infants rolled out by the Ministry of Health earlier this year. Doctors and midwives were trained in January by experts from CDC. The new procedure is bloodless and requires no anesthesia or suturing.

Health officials say that not only will infant circumcision help protect boys from HIV when they become sexually active later in life, but that it also protects infants and boys from serious health complications such as urinary tract infections and paraphimosis, a condition that can lead to pain and swelling of the penis and may require surgery.
...
The rollout of Early Infant Male Circumcision in Botswana may be one of several indications that the Safe Male Circumcision (SMC) program has turned a corner in Botswana. Between April 2013 and February 2014, the national SMC program recorded 42,679 circumcisions, about 85% of its annual target and 10,000 more than the previous year.

More targeted demand creation campaigns and a fleet of new mobile outreach clinics may help explain the recent upsurge in voluntary circumcisions in Botswana. Or perhaps it’s the promise of new SMC devices that make the procedure easier and faster.

The U.S. government through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported Botswana’s SMC program from its inception in 2009 with nearly $25 million and technical assistance over the past five years. In 2013, PEPFAR restructured its support to a single-partner model and chose Jhpiego, a development organization affiliated with Johns Hopkins University, as the single implementing partner for all CDC-funded activities related to the SMC program.

The Ministry of Health also plans to roll out the PrePex male circumcision device following the completion last year of a six-month pilot study sponsored by PEPFAR.
...
“If we can integrate infant circumcision into the maternity wings and convince mothers that this is a good idea, this one can be a big win,” says Conrad Ntsuape, the national SMC Coordinator.

URL: http://www.cdc.gov/globalaids/success-stories/botswana_success.html

2015-09-23 Daily Monitor - Editorial: Check forced circumcision

Excerpt:

We reported last week about the forced circumcision of 25 pupils from Oderai Primary School in Soroti Sub-county, Soroti District in eastern Uganda. The exercise, which targeted pupils of 11 and 15 years, is said to have been facilitated by a non-governmental organisation.

The exercise was a traumatic one for the pupils some of whom had adverse reactions to the circumcision. According to their parents, one pupil disappeared while another refused to return to school.

The Ministry of Education should intervene in this matter to establish how the school administration managed to overstep their mandate to the extent of sanctioning such a life-changing medical procedure on underage individuals without their parents’ consent.

In fact, the entire district administration should be investigated because the school head claimed she released the pupils due to the involvement of district medical workers.
The official claim is that the district workers were merely doing their duty as per a government programme sanctioned by the district. However, if there are complications arising from this exercise, ultimately it is the parents who will bear the cost of medical bills and emotional trauma.
...
The hurried way in which the circumcision of the Soroti pupils was done raises questions about the objectives of those who carried it out. Is this a district wide exercise that they intended to carry out in other schools? Authorities in the ministries of Health and Education should come out and pronounce themselves clearly on this exercise.

URL: http://www.monitor.co.ug/OpEd/Editorial/Check-forced-circumcision/-/689360/2881298/-/rjd7hbz/-/index.html

2015-09-19 Daily Monitor (Uganda) - Parents protest forced circumcision of children

Cite as:  Onyango, J.E. (2015) Parents protest forced circumcision of children Daily Monitor 19 September 2015 Full-text available at http://www.monitor.co.ug/News/National/Parents-protest-forced-circumcision-of-children/-/688334/2876206/-/gvf444/-/index.html Accessed: 28 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/09/2015-09-19-daily-monitor-uganda-parents.html

Excerpt:

Parents have protested the circumcision of their underage children studying at Oderai Primary School in Soroti sub-county, Soroti District.

At least 25 pupils were circumcised on Monday without consent of their parents and most of them have since not returned to school.

The exercise targeted children from Primary Three to Primary Seven aged between 11 to 15. They were circumcised at Soroti Health Centre III. The exercise was facilitated by Baylor Uganda, a non governmental organisation.

Parents said the circumcised children preferred to stay back at their respective homes because they are still feeling pain.

Archived URL: https://web.archive.org/web/20151028045624/http://www.monitor.co.ug/News/National/Parents-protest-forced-circumcision-of-children/-/688334/2876206/-/gvf444/-/index.html

2015-09-16 Daily Monitor (Uganda) - Baby loses penis during circumcision

Cite as: Basiime & Atuhaire (2015)  Baby loses penis during circumcision Daily Monitor 16 September 2015 Full-text available at http://www.monitor.co.ug/News/National/Baby-loses-penis-during-circumcision/-/688334/2871830/-/9w2t1t/-/index.html Accessed: 28 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/09/2015-09-16-daily-monitor-uganda-baby.html
 
Excerpt:

Kabarole. A six-months-old baby in Fort Portal has lost his penis during circumcision, a procedure his mother claims she never authorised.
Ms Rosette Katushabe, a resident of Rwengoma village in Fort Portal municipality, says her baby was on September 2 circumcised by a sheikh without her consent.
...
Previous cases
In 2013, a 44-year-old lost his penis to a botched male medical circumcision procedure in a private clinic in Kawempe Division, Kampala. The man said the circumcision was free, but he had to pay shs20,000 for the drugs. He said he woke up three hours after the procedure to find his penis stiff and was removed days later at Mulago hospital when it darkened and began peeling off.

Archived URL: https://web.archive.org/web/20151028042614/http://www.monitor.co.ug/News/National/Baby-loses-penis-during-circumcision/-/688334/2871830/-/9w2t1t/-/index.html