Given that this procedure has a minimal ground cost, and a high relative effectiveness, it is somewhat surprising that it has yet to be implemented among many African countries. Currently, only 3% of the African sexually active male population is recorded as being circumcised. Leading authorities - including such leaders as the World Health Organization, and the Bill and Melinda Gates Foundation - hope to implement a new program that would have as a goal circumcision of 80% of the 15-49 yr old male population among 14 African countries. Right now, major barriers lie among lack of support from local governments, often due to cultural misconceptions - also, the dilemma that in some areas only physicians (rather than nurses or other medical professionals) would be considered adequately trained enough to perform the procedure.
Right now, as so often seems to be the case, the major solution seems to be education: education of the population regarding the benefits of circumcision, education of medical officials as to the procedure itself, and the recurring education of safe sex practices. Another promising approach is the implementation of new plastic rings (the Shang Ring and PrePex) which, when attached around the foreskin of the penis for a week, cuts off its blood supply and therefore allows for its removal sans suture. The promise of a circumcision that wouldn't require anesthesia is a more appealing option to many sexual active African men, and is therefore expected to increase circumcision rates. Hopefully, this combination of both new and old practice will help to definitely decrease the rate of HIV overall in Africa.
Original article: http://www.nytimes.com/2011/09/27/health/27circumcision.html?pagewanted=2&_r=1&sq=hiv&st=cse&scp=3
- Elena Higuchi