The dilemma of circumcision for Hindus

[Guest guest]

The dilemma of circumcision for Hindus

Over the last 25 years I have often heard comments and talks by many

public health officials and STI and skin specialists that circumcision reduces

the risk of many fungal and bacterial infections and that this vulnerability

become more pronounced with age. Similarly, there is talk of reduced risk of

cervical cancer to partners of circumcised men.

Since 1989, over three dozen not fully rigorously controlled studies have

indicated that circumcision reduces the risk of HIV infection to the male

(inserting) partner. Nevertheless, in both 1992 and 1997, when we had to make a

choice with respect to our boys, we got no clear answer!

This issue has acquired clarity with the study of Dr. Bertran Auvert of the

University of Paris and Puren of South Africa's National Institute for

Communicable Diseases in South Africa (2005), and results of two more recent

studies in Kenya and Uganda, that circumcised men have about 60% lower risk of

contacting HIV when having sex with an infected partner. Assuming that these

findings are correct and universally applicable – what do they imply for Hindus

for whom not being circumcised is part of their religious identity?

In addition to the question of religious identity I am stumped by two

additional educational challenges that need to be overcome if we are to achieve

behavior change for a large society – Hindu India.

1) In a country where only about 30 percent of births are in registered medical

facilities, how does one guarantee implementation of proper sterilization

procedures for circumcision? How high would be the risk of infection from

circumcision in India and is that an acceptable risk?

2) How does one educate a parent that circumcision will protect their

precious male child from HIV (a stigmatized infection) if the child

indulges in risky sex (unimaginable) once he grows up? In other words, how does

one ask parents, in a country where parents have a strong belief that a child

will grow up to be what they wish for him, to take preventive action against

possible risky behavior, say 20 years into the future?

I am at a loss on how to develop a compelling strategy that will allow parents

to contemplate such risky behavior by their precious newborn and to take

preventive action at such a joyous moment, when their overriding belief is that

by even entertaining such thoughts they have doomed their son to that fate?

I will be very grateful to forum members for their suggestions,

solutions, or attempts at developing appropriate educational material

based on their experiences in this regard.

Sincerely

Rajan Gupta

e-mail: <rajan@...>

http://t8web.lanl.gov/people/rajan/AIDS-india/