AIDS DEATHS IN KENYA HAVE fallen by 29 per cent since 2002 — thanks to the use of anti-retrovirals and a concerted awareness campaign.

New studies show that current HIV interventions are saving lives and slowing the rate of new infections in Kenya. Some 300,000 people, including children, are on the life-sustaining drugs, according a UNAids report released ahead of the World Aids Day marked on Tuesday.

But there is a growing danger of these gains being reversed, especially in Nyanza Province, where the government is leading a male circumcision drive to fight HIV and Aids despite the bitter debate about the benefits of the ‘cut’.

Although it was initially opposed by the Luo Council of Elders on ethical and cultural grounds, the old folk have since decided to keep their counsel.
So far, 60,000 men across the country have been voluntarily circumcised in an exercise conducted by the Health ministries. The campaign, through the Rapid Results Initiative, has gone to rural Nyanza and runs up to the end of December.

But the widespread ignorance about how far circumcision can prevent infection threatens to lead to an upsurge of the disease. The initiates, especially youth, believe the surgery offers them new sexual freedom.

Every charlatan and quack in rural marketplaces is ready to perform the operation to cash in on this misguided enthusiasm. Efforts to encourage safe sex have been relaxed as people rush to make money from the drive that mainly targets members of the Luo community who have not fully embraced circumcision as a cultural practice.

Studies show that male circumcision can reduce the risk of heterosexually acquired HIV infection in men by approximately 60 per cent. I have no reason to doubt the experts. They also say the cut can stop infections from easily developing under the foreskin. The operation also reduces the risks of penile and cervical cancer and urinary tract infections.

THESE ARE CERTAINLY GOOD ENOUGH health reasons for the procedure, and aware of the long-term advantages, quite a number of Luo parents have been taking their infant sons and even older children to hospital for the simple surgery without a fuss. Other members of the community are being circumcised for purely aesthetic reasons.

But linking mass male circumcision to the Aids fight without proper information perpetuates the fallacy that it offers total protection. The growing reckless sexual behaviour and even flippancy about the exercise shows there is a lapse that could put into further peril communities already hard-hit by the scourge.

Male circumcision to prevent Aids is pushing other healthcare programmes, including other HIV and Aids interventions to the back-burner, yet we can only maximise benefits and ensure longer-term sustainability of services by successfully integrating it with other services.

The virus is still spreading fast in Nyanza due to people’s deeply-entrenched cultural practices. I believe more effort and resources should go into fighting harmful traditions like wife-inheritance and polygamy that are fuelling this spread. Misinformation or inadequate information can only make the situation worse.

These new initiates and their sexual partners are clearly developing a false sense of security and engaging in high-risk behaviour that could undermine the partial protection provided by the cut.

Let the government carry on the male circumcision drive by all means. But it must not leave the job to quacks. A full awareness package is necessary.

Ms Odalo is a Business Daily sub-editor