Promoting Male Circumcision for Hindus
This blog has dealt with ethical questions about male circumcision and HIV before, but somehow the assumption crept in that this is a distinctively African controversy. Maybe it was because of the high HIV prevalence in that part of the world. Maybe its was because of the longstanding interest -- especially among anthropologists -- with circumcision rituals in Africa. Let us make a confession here: the author of this post has co-authored an article in the Journal of Medical Ethics called Male Circumcision and HIV Infection: Ethical, Medical and Public Health Tradeoffs in Low-Income Countries. And it too is guilty of identifying the issue a bit too much with sub-Saharan Africa. Whatever way this came about, the ethical questions concerning the promotion of male circumcision to lower risk of HIV transmission have to embrace India. For one thing, the number of new HIV infections has rising in India dramatically over the last years. For another thing, male circumcision is a highly charged matter, both politically and religiously, when Hindus do not traditionally circumcise and Muslims do.
An article in the Times of India today gives an indication of just how sensitive the question is. The National AIDS Control program in India will not even think of conducting randomized controlled trial to test whether being circumcised lowers a man's risk of getting HIV infected: not because three such studies have been done before, but the whole idea seems too hot to handle. When Richard Feachem, Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said that he expected that Hindus would increasingly have more HIV infections because their men do not get circumcised, his inbox was inundated by hate mail. The issue is inseparable from the larger relationship between mainly Hindu India and its Muslim neighbor and rival, Pakistan. The foreskin has geopolitical significance.
The question is: when circumcision acts as a religious/cultural marker from neighboring groups, will men still agree to do it, to reduce their chances of getting HIV? A World Health Organization/UNAIDS meeting in Switzerland on March 6 is set to tackle these tradeoffs between cultural identity and public health, among others. When HIV infections globally are increasing, vaccines are probably at least 10 years away, and the once-promising microbicides are crashing and burning, the ancient practice of male circumcision is strangely enough carrying the torch in the fight against HIV/AIDS.
-Stuart Rennie
Labels: circumcision, Haiti, HIV, Journal of Medical Ethics
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This is definetlly a difficult situation. Even if you can offer proof scientifically that male circumcision can and will reduce the risks of getting HIV you still have to deal with the group of peoples religous backrounds. I feel that good education and proof that male circumcision does reduce the risk of HIV could hinder some people into making this type of choice but, I higly doubt you are going to chance eveyones opinion and belief in their religous backrounds. For the people that do not decide to do male circumcision due to religion then I feel that better education on safer sex practices is definitaly a good focus.
- by Scot Guidash on Feb 26, 2007 at 6:55 PM | link
I think this might be a little trickier than promoting circumcision in Africa. It's true that some people in Africa are opposed to circumcision for religious reasons, but some parents just simply neglect to circumcise their children for no apparent reason, not because they are oppose to it, for this reason, educating them would help. But to tell people to go against their religion? I could see that meeting a lot of opposition, probably the same opposition as trying to convince Jehovah Witness to receive blood products. I think in Islamic religion if a treatment it deemed ABSOLUTELY NECESSARY you are allowed to go against the rules(Im not even sure about that), but I dont see circumcision as being ABSOLUTELY NECESSARY, there are other options such as use of condoms and decreased sex partners.
- by Althea on Feb 27, 2007 at 5:38 PM | link
I think this might be a little trickier than promoting circumcision in Africa. It's true that some people in Africa are opposed to circumcision for religious reasons, but some parents just simply neglect to circumcise their children for no apparent reason, not because they are oppose to it, for this reason, educating them would help. But to tell people to go against their religion? I could see that meeting a lot of opposition, probably the same opposition as trying to convince Jehovah Witness to receive blood products. I think in Islamic religion if a treatment it deemed ABSOLUTELY NECESSARY you are allowed to go against the rules(Im not even sure about that), but I dont see circumcision as being ABSOLUTELY NECESSARY, there are other options such as use of condoms and decreased sex partners
- by Althea on Feb 27, 2007 at 6:26 PM | link