The DHS (2006) of Swaziland also reported that HIV prevalence among circumcised men is 22% and 20% for uncircumcised men. It is argued that this was probably due to the fact that those who were circumcised had not removed their entire foreskin as it is done in medical settings. I find this explanation not credible. In Swaziland, the so called ‘bush circumcisions’ are extremely rare. MC is mostly offered in medical settings so the majority of those who were circumcised were circumcised by medical professionals and they normally remove the whole foreskin.

Findings from the 18 countries with data present a mixed picture of the association between male circumcision and HIV prevalence. In eight of the countries (Burkina Faso, Cambodia, Côte d’Ivoire, Ethiopia, Ghana, India, Kenya, and Uganda), HIV prevalence is higher among men who are not circumcised, although the difference between circumcised and non-circumcised men is slight, except in Kenya, where the difference is substantial (HIV prevalence of 11.5 percent for non-circumcised men compared with 3.1 percent for circumcised men). In 10 of the countries—Cameroon, Guinea, Haiti, Lesotho, Malawi, Niger, Rwanda, Senegal, Tanzania, and Zimbabwe—HIV prevalence is higher among circumcised men.

Cumulative probabilities of female HIV infection at 24 months were 21·7% (95% CI 12·7-33·4) in the intervention group and 13·4% (6·7-25·8) in the control group (adjusted hazard ratio 1·49, 95% CI 0·62-3·57; p=0·368) (Wawer et al. 2009). From this trial, it means that MC increases the probability of male to female HIV transmission if the male is circumcised while HIV positive.For some reason, results from such studies seem to be obfuscated and MC campaigns in Swaziland do not warn women about this. I find this ethically wrong.

The authors concluded that “among uncircumcised men who intended to get circumcised in the future,72.4% intended to get circumcised in the next 12 months” (PSI 2010:6). I argue that their study suffered from desirability bias.
PSI is arguably one of the leading NGOs in the country in providing MC and other HIV prevention interventions.

Also, in some cases PSI and other NGOs implementing MC have used incentives to lure males to come for MC.

Even more worrisome, circumcised men were more likely to report a high number of lifetime partners. This indicates that this feeling of security is transformed into dangerous practices.

Since most of the circumcised men stated that MC actually decreases their sensitivity during sex, they argued that there were other ways to improve their sex life. These strategies ranged from using lubricants during sex, trying different sex positions and not using condoms for better sensitivity. According to both circumcised and uncircumcised men, the penis head gets harder and consequently less sensitive. The notion that the penis head gets keratinized (Dinh et al. 2010) sparked more response from the uncircumcised men. An uncircumcised male who had just completed his high school education said:
Those that are circumcised say that in bed it is good for the woman to sleep with a circumcised man. But for you as a male it is not nice. This means you are doing it for the woman. You know as a guy the foreskin can play tricks on you and you ejaculate quickly before the woman reaches climax. So why is the foreskin removed if it helps during sexual intercourse? So without the foreskin it means that you just insert the head and it takes a long time to sense her and then ejaculate.

Yes I would agree with that. I now take longer to ejaculate. And sometimes you can end the sex session while you have not even ejaculated. I am talking through experience and this is painful (a painful experience). Sometimes by the time you finish you find that the woman is already too tired because of my delayed ejaculation. So I would say that the foreskin has a role during sex. My main complaint is delayed ejaculation or not ejaculating at all.

But I do not regret too much because I am safer from STIs and I can now easily clean myself.

A friend of mine lied to me and he said after getting circumcised I would enjoy sex better. Also, the MC Ambassador was telling us that you would enjoy sex better after sex. But now it (penis gland) is almost like rubber and there is no longer that feeling when entering the female.

People have these questions and they accuse MC proponents of not telling the truth about circumcision and only painting a good picture about it. This clearly shows that biomedicine lacks information in this part.

Most participants (both males and females) seemed to have suspicions regarding HIV interventions. They reported that HIV had become a big business and saw interventions such as MC as part of that business.

To my surprise, most of my findings were not in harmony with the literature reviewed. For example, fear of loss of sexual pleasure was not found in most literature reviewed in this study.

To find out why circumcision had been so unpopular among
Swazi men, Adams interviewed men in the Kwaluseni district of
Manzini, Swaziland through a mix of focus group discussions and
interviews. He found that because men feared reduced sexual
pleasure and possible adverse effects, Swazi men felt the
procedure threatened their notions of manhood.
“A real Swazi man is defined as someone who has a wife and
children, and is able to take care of family,” Adams told the
conference. “In order to have a wife and children, a man has to be
sexually functional – the issue of circumcision introduced a threat to
this.”
Nonetheless, the three large randomised clinical trials found that
only a small percentage, between 1.5 and 3.8%, of circumcisions
resulted in complications such as wounds or swelling.

Zimbabwean senator, Sithembile Mlotshwa, believes male circumcision is causing a lot of havoc in most southern African communities as circumcised men forgo the use of condoms.

Major donors include the governments of the United States, United Kingdom, Germany and the Netherlands;

EIMC is likely to be an acceptable HIV prevention intervention for most populations in Zimbabwe, if barriers to uptake are appropriately addressed and fathers are specifically targeted by the programme.

More than 8,900 staff work for PSI and its affiliates.

PSI’s Research Ethics Program is responsible for the ethical and regulatory compliance of research at PSI that involves human subjects. PSI is committed to protecting the rights and welfare of subjects enrolled in its research activities.

Matsapha- PSI Swaziland has advanced the male circumcision programme by launching an Early Infant Male Circumcision Programme that allows new born babies to be circumcised.

There are no lasting negative health outcomes for men...

It's really cool - and very quick - and painless!

There is no need for follow research....

In countries where every male is circumcised the HIV prevalence has never gone above 5 or 6 %, even when you compare people with exactly the same behaviour.

The DHS (2006) of Swaziland also reported that HIV prevalence among circumcised men is 22% and 20% for uncircumcised men.

It has an efficiacy in excess of 60%
In other words if you vaccinate 100 people, 60 would be protected by that...