Male circumcision, female condom reduce HIV infection risk

The Manilla Times, April 7, 2001

By Henrylito D. Tacio

Male circumcision—the removal of all or part of the foreskin of the male sexual organ—may reduce HIV infection risk by approximately 50 percent.

In sub-Saharan, where most studies have been done, male circumcision is "statistically associated with a reduced rate of HIV infection," according to Washington-based Population Council, Inc. As such, male circumcision is seen as a "potential new intervention for reducing HIV incidence." This is particularly true in sub- Saharan, where HIV/AIDS has become a major public health problem of almost unmanageable proportions.

Unfortunately, little is known about the acceptability, feasibility, safety, and cost-effectiveness of male circumcision in different parts of sub-Saharan Africa, especially among uncircumcised populations, among whom the introduction of male circumcision has the greatest potential impact.

Research also suggests that the protective effect against HIV infection is most pronounced if the procedure is done before the onset of sexual activity. It has been reported that in most parts of sub-Saharan Africa, circumcision is typically done as part of initiation to manhood rites, at ages ranging from 10 to 20 years or even older.

Anecdotal evidence suggests that male circumcision is perceived in some areas of the region as protective against HIV infection, and has even been referred to as the "invisible condom."

This alarms the International HIV/AIDS Alliance. "Perceptions of protection (among circumcised men) may lead to increased risk behaviors, including reduced condom use," the alliance points out.

"Any male circumcision intervention should include HIV prevention education, counseling and behavioral change interventions, and sustained promotion of condom use," it suggests.

Speaking of condom, the female condom has also been found to reduce the risk of HIV transmission. "The use of barrier methods like female condom is one of the few behavioral strategies that women can adopt to protect themselves against the sexual transmission of HIV," says the Population Services International (PSI).

With female condom, women said that there are no longer forced to rely on the male controlled methods of contraception. Manufacturers insist that the condom is as efficient and effective as its male counterpart "when used correctly."

The female condom is a strong, soft sheath that is inserted into the
female sexual organ before sexual intercourse. It has two plastic
rings: one at the close end, which helps insert the condom and keep
it in place, and the other at the open end, which remains outside the
According to the Joint United Nations Program on HIV/AIDS (UNAIDS), the female condom can be inserted quite a while before having sex and does not require immediate withdrawal after ejaculation.
The UNAIDS reminds that female condom is not meant to replace the male condom. "Rather, it is meant to increase the options available to fight HIV and other sexually transmitted infections (STIs)," the UN agency says.

A study conducted in Thailand among sex workers in brothels showed that when a female condom was provided as an extra option to the male condom, the women experienced a 34-percent decrease in the number of new STIs.

The same study also found that sex workers who had access to both the female and male condoms were less likely to have unprotected sex than women who had access only to male condoms.

Several studies done in Africa, Latin America and Asia showed that once women try the female condom, they like it. In a Thai study, four out of five sex workers who agreed to try a female condom said they were satisfied and would use it again. In Zimbabwe, more than three-fourths of married and single women say they would use the female condom again, compared with 54.7 percent of married women.