Cut or uncut?

Call it religious chauvinism, or perhaps just good taste, but I’ve always preferred cut. Granted, I lost my foreskin more than 40 years ago, presumably at a catered function where I cried (as did my mother) and everyone else chased mouthfuls of chopped liver with cola tonic and lemonade. Since then, I have not spent a minute wishing it would one day grow back, as some men apparently do. And when confronted with the choice on any of a number of online “dating” sites, I always consider the “Cs” before the “UCs”.

So when it comes to the so-called debate regarding medical male circumcision and HIV prevention, I’m perhaps not a neutral observer. But then, which man is? The penis is either snipped or unsnipped — there is no neutral option.

After more than 25 years of the global HIV/Aids pandemic, we have not come very far in preventing new infections. Great strides have been — and continue to be — made in the science of treatment, but on the prevention side, we have much further to go. In this country, we have seen just how limiting — and often counterproductive — the ABC message has been. So far, even partially effective vaccines and microbicides have yet to be developed. But although somewhat frustrating, the prevention battle is not devoid of hope, given that a range of proven interventions have been identified.

But before you all yawn, let me reassure those who have read this far that I will not speak about the need for better access to improved regimens for preventing HIV transmission from mother to newborn child, or for serious attention to be placed on developing harm reductions interventions before the drug-use epidemics we have in certain parts of the country become — in terms of new HIV infections — out of control. Instead, I will recount a little bit of silliness that attempted to pass for intellectualism at a recent conference.

At issue was how the country should respond to the overwhelming scientific evidence that shows that male circumcision significantly reduces the risk of HIV infection for men who have vaginal intercourse with women. I’m not sure why we were debating this issue when our new strategic plan on HIV/Aids — endorsed by the National Aids Council and adopted by the Cabinet — recommends that the Department of Heath “consider the effectiveness of male circumcision as an HIV-prevention intervention and develop appropriate policies”.

The same plan recognises that the World Health Organisation and the Joint United Nations Programme on HIV/Aids “issued recommendations on male circumcision for HIV prevention” earlier this year. In my view, as the plan suggests, we should rather be discussing how — and not if — South Africa is going to introduce an intervention of proven efficacy. Implementation won’t necessarily be simple, but it does seem inevitable. But I digress — again — from my task at hand, which is to recount the moment of profound inanity.

In suggesting that we proceed with caution, a delegate spoke glowingly of a study that suggests a link between male circumcision and domestic violence. No citation, no mention of methodology — just a claim that the loss of a foreskin is likely to turn a man into an abuser. A colleague of mine, who was outraged by what turns out to be particularly uninformed comment, told the conference that the study relied upon was … well … not particularly reliable. Like me, he was also disconnected from his glans as an infant.

While I have yet to locate the study, or any other of a similar nature, I have it on good authority that there is no evidence to support the circumcision/violence hypothesis. To the contrary, it turns out that while a correlation between circumcision and domestic violence may well have existed among the Nordic study sample, a range of other factors — such as inequality, dislocation and migration — better explain the violence. Unsurprisingly, levels of domestic violence among the relatively more affluent, well-settled (and uncircumcised) locals were lower.

As I started to write this entry, I was listening to a TV advert telling me how to ensure 36 hours of freedom — tragically too late for me on a Sunday evening. In any event, my lack of “freedom” this weekend had nothing to do with blood flow to my nether regions, but rather much to do with tragically poor chat-room skills. Which leads me to think that perhaps I should be worried for all the men around me if I were to get my hands on that magic pill. Just imagine, a circumcised fag even more ready to rock’n’roll at any moment from now until Tuesday morning!