Circumcision promoting risky behaviour – report

A new study of 314 female sex workers (FSWs) in Makindye division found that more than half of respondents falsely believe that once a man is circumcised, protection is not necessary during sex.

The International Health Sciences University (IHSU) study was titled: “Understanding the dynamics and practices of female sex workers with both circumcised and uncircumcised men in Makindye division.”

It was done in the Kampala suburbs of Kabalagala, Kansanga, Makindye II, Kibuye, Katwe, and Ggaba, between July and August 2013. Although there is no significant difference in sexual practices between circumcised and uncircumcised men, there is a misconception about the advantages of male circumcision among FSWs.

Of the interviewees, 17.7 per cent preferred having sex with circumcised men because they believe the risk of HIV infection is nil. Some 20 per cent of the 60 FSWs that reported to be HIV-positive had not used a condom in their last sexual encounter before the interview. One interviewee summed up the misconception of using circumcision as a ‘natural condom’ this way:

“A man who is not circumcised takes long to ejaculate and at times such men want to have sex with you without a condom such that they can infect you. But a man who is circumcised can even rape you without a condom and you do not get infected.”

With regard to condom use, 187 (72.5 per cent) said they used condoms with steady clients every time while 67 (26 per cent) said they used condoms occasionally.

“Meanwhile, four FSWs (1.5 per cent) said they never used condoms with their steady clients and three of these did not think that circumcised men could infect someone with HIV yet they had had STIs in the past three months,” the report partly reads.

The report notes that the 60 per cent protective effect from HIV/Aids that is associated with safe male circumcision (SMC) is likely to trigger a high propensity for risky sexual behaviour and worsen the incidence of HIV.

Data from the ministry of Health indicates that about 137,000 new infections occurred in 2013, a decline from 160,000 and 143,000 in 2011 and 2012 respectively. The ministry aims to circumcise four million adult males by 2015 and has set an annual target of one million.

Last year, 742,000 circumcisions were done.

Other findings

• Majority of the respondents were in the age group of 18-24 (49.4 per cent) and had achieved a primary level of education.

• 118 (37.6 per cent) FSWs were single while 5.1 per cent (16) were married and 18.5 per cent were in relationships with stable partners. However, for the 51.3 per cent of those who were in stable relationships, their partners did not know that they were sex workers.

• Of those who pointed out forced unprotected sex as a challenge, 19 per cent were HIV-positive.

ninsiima@observer.ug