There is a dramatic shift in attitudes toward circumcision in Swaziland, which has one of the world's lowest rates of the practice and one of the highest HIV prevalence rates.
Circumcision, once widely viewed as unmanly, it is making a sudden comeback in the country since the publication of a South African study that finds the practice could reduce the risk of contracting HIV.
According to the study published in the November 2005 issue of PLoS Medicine, male circumcision might reduce the risk of men contracting HIV through sexual intercourse with women by about 60%, in Kaiser Daily HIV/AIDS Report in November 2005, Hundreds of Swazi men have been circumcised in recent months, and hospitals that were rarely approached for circumcision earlier are now circumcising 10 to 15 patients weekly, with a two-month waiting list.
The UN officials in Swaziland have turned circumcision advocates and have aggressively publicized the study by incorporating messages about the protective effects of circumcision into public education campaigns and meeting with Swazi physicians to discuss the research. In addition, Swazi legislator Marwick Khumalo advocates the practice in "Swazi terms" by telling parents that their paternal bloodline depends on protecting their sons from HIV.
However, some circumcision advocates say that newly circumcised men might believe that they are "totally protected" from HIV and take to high-risk sexual behavior, while in fact they are highly vulnerable to HIV in the weeks after circumcision until the wound heals, when the virus can enter the body through the wound.
Some Swazi health care providers say if the country's health system cannot meet the demand for circumcision, the surgery might increasingly be performed in ritual settings or hastily established operating rooms which are far from hygienic. Swaziland's health care system already is overwhelmed with providing HIV/AIDS care, distributing antiretroviral drugs and retaining its short supply of health care workers.
To address the issue, mobile military hospitals are being thought of to provide circumcision in villages at no cost to males between the ages 10-24.
However, the largest international supporters of HIV/AIDS prevention have treated the results cautiously and are waiting for results from similar studies in Uganda and Kenya before deciding whether to offer circumcision more widely in countries with high rates of HIV.