President Yoweri Museveni has said it is not enough to promote circumcision as an effective strategy in fighting HIV/AIDS, without continued emphasis on behaviour change.

Campaigns aimed at reducing infection levels, he says, ought to concentrate on advocating good behaviour: abstinence for unmarried people and faithfulness among those in wedlock.

“I have witnessed Muslims and other people from tribes that cherish circumcision like the Bagisu, die of Aids. Therefore, who told [health workers and leaders] that circumcision [prevents] HIV [infection]? ” he said.

Museveni was speaking during celebrations to mark 100 years of Mbarara High School in Mbarara district, Saturday. The school was started by Ankole kingdom and the Church Missionary Society of England in 1911. Several distinguished Ugandans, including President Museveni, are old students of the school. Museveni was there for junior secondary from 1959 to 1960.

At the centenary celebrations, Museveni advised leaders and health workers to sensitize the youth about the dangers of peer pressure, saying many young people have been influenced by their friends into engaging in early sex and pre-marital sex and early marriages, not in getting circumcised to avoid being infected with HIV.

“[Leaders and health workers] are busy spreading confusion of circumcision, instead of concentrating on behaviour change,” he said.

According to the World Health Organisation and UNAIDS, there is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. WHO/UNAIDS recommendations emphasize that male circumcision should be considered an effective intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.

However, they add, male circumcision provides only partial protection and should, therefore, be only one element of a comprehensive HIV prevention package which includes: provision of HIV testing and counselling services; treatment for sexually transmitted infections; promotion of safer sex practices; provision of male and female condoms and promotion of their correct and consistent use.

The ministry of Health and various partners in Uganda, including local government leaders, are promoting circumcision throughout the country and equipping health centres IIIs, among other health facilities, to conduct safe male circumcision.

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0 #1 Kakaire A.K 2012-07-23 07:29
Good piece of journalism Wilber. Many journos who do such stories should borrow a leaf from you. Well done for countering Mr Museveni's misinformed opinion with what science says about what medical male circumcision can and cannot do in the context of HIV infection from woman to man. More grease to your elbows.
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+1 #2 Hugh7 2012-07-23 09:39
President Museveni is quite right that circumcision alone is not enough - if it does any good at all - but he ought also to mention the measure that is most effective in the real world, when people are neither abstinent nor faithful - condoms.

Why is there such beating of the drum for circumcision, when it may even INcrease the risk to women, who are already at greater risk?
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0 #3 sammy t 2012-07-23 09:52
Thank you Mr President...its one of the few times i support you. This circumcision nonsense should just stop ...The so called "compelling evidence" is now seriously being disputed by leading scientists.

It was an overwhelmingly flawed study that is why it is only in Africa that circumcision is being promoted.Of course it is now a cashcow for those in the lucrative HIV/AIDS industry.

The more foreskins chopped,the more cash..thats why you find respectable doctors shamelessy supporting this fraud! In europe there are even calls for the practice to be banned being performed on babies!!(German y).

It is only behaviour change and consistent and correct condom use that will stem HIV. Besides who says the male foreskin has no serves a sexual function and makes sex more pleasurable for both male and female. About hygiene..just bathe...simple
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+3 #4 Jane 2012-07-23 12:59
Data does not lie. The HIV transmission rates are increasing while at the same time circumcision rates are also increasing. The myth of the effectiveness of circumcision does not add up.

I dare say the increased promotion of circumcision amongst men may be the single biggest factor in increased rates of HIV. Short of keeping it zipped up, men should always use condoms with partners they aren't sure about.
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0 #5 Betty Long Cap 2012-07-23 17:30
Quoting Jane:
Data does not lie. The HIV transmission rates are increasing while at the same time circumcision rates are also increasing.

There certainly is no causal relationship between increase rates of circumcision and increased spread of HIV/AIDS and no high and positive correlation. At best circumcision slows transmission of the virus.

In a continent where more and more men are down low, any help is a help.
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+3 #6 Khadijja Nampiima 2012-07-23 22:03
I never thought that I would agree with President Museveni on anything but I have to swallow my pride and accept the fact that I totally agree with him on this circumcision crap.

Indeed what we need is behaviour change not more circumcision. Associating circumcision with Aids reduction is reckless nonsense.
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0 #7 kuwose 2012-07-24 13:53
M7 ,for sure,is a tired leader.No better indication.Some one tell him that no body has ever said that circumcision is a vaccine.Every one advocating SMC will tell you that not even condoms are 100% because there people who have contracted HIV through misuse or misharps of condoms.

On the other hand,Amref and the other experts(of which M7 is not) will tell you that amongst people who practice circumcision,th e prevalence among males is significantly lower than those without,ceteris paribus.

But again,when he was in Mbale recently,M7 hailed the Bamasaba for practising a ritual that compliments his government's fight against the epidemic,prompt ing the youths there to enforce it against non Bamasaba in Mbale in what they saw as voluntary operation "Boosi Basyete''(or Bona batayirirwe,if you like).
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+1 #8 RicardoD 2012-07-24 14:02
In Washington yesterday at AIDS2012 conference it was announced that effort to control AIDS in Africa is 7 billion US dollars short.

Why are UN AIDS and US PEPFAR continuing to waste money on useless circumcision when people are dying because the program is stalled (yes, they said it: People are dying). There is a shortage of ARV drugs and other essential supplies, yet they continue their madness about circumcision which does not work unless one uses a condom after being circumcised. Yes, that's right.

So why not just use the condom without bothering with circumcision? Is it about decreasing AIDS cases, or about increasing circumcision events?
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0 #9 Betty Long Cap 2012-07-24 17:38
Quoting RicardoD:
people are dying because the program is stalled (yes, they said it: People are dying).

At the risk of sounding politically incorrect, will anyone connect the spread of HIV/AIDS with immoral sexual behaviour? The exceptions to that just prove the rule. To state the obvious: AIDS is a sexually transmitted disease (STD).

God is not a clockmaker who set the world in motion and removed Himself from human affairs. He has always used sword, pestilence, and famine to punish nations.

Amazingly, Elton John said he should have been dead by now. Still he does not change his behaviour. He is cast.
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+1 #10 Lynn 2012-07-24 21:37
Male circumcision is a waste of time and money. Having a foreskin is not the cause of HIV. Having sex with an HIV positive person is the cause of HIV. Use condoms, abstain, and if you're in a relationship, don't sleep around.

It's that simple. All circumcision is doing is wasting precious funds and giving men the delusion that they will be 100% protected from HIV if they cut off part of their penis, which will no doubt lead to more HIV infections. In many countries, like Zimbabwe, circumcised men have higher HIV rates than uncircumcised men.
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0 #11 Betty Long Cap 2012-07-24 23:10
If husband and wife are in a monogamous relationship, circumcision becomes a non-issue.

The situation in Zimbabwe, suggests a lot of men are on the prowl or down low and are convinced circumcision will slow down the transmission of HIV/AIDS virus.
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