From Rome comes the news that adult male circumcision reduces the chances of HIV transmission from women sex partners to men by up to 60 percent. “Is that all?” thought the member (of the Upper Jukskei Fly-fishing Collective). “Just 60 percent?” He would have thought that for a sacrifice of, say, as much as 10 percent, the return on investment would have been far greater.
Still, we should count ourselves lucky. If Caesar’s demand had come from a medical conference in Venice, it would have been for a pound of flesh, and who can say what percentage that would amount to. Imagine the feeble protests from the waiting rooms in the health department’s thousands of newly constructed block houses dotted across the country. “You want 10 percent of what? How do you want it? Tumescent or flaccid?”
And let there be no doubt that the news from Rome is in fact an instruction from our Health Minister Aaron Motsoaledi, who voluntarily subjected himself to just such a penis reduction exercise in the course of a three-year campaign in the Orange Farm Township south of Joburg. The order may not yet be enforceable by our courts, but the state’s influence and manipulative powers make it no less compelling an instruction to naive boys and men than if Josef Mengele backed up by a squad of jackboots banged on the door of your shack: “Open up. It is the Penis Police.”
Rome issued its instruction ostensibly based on a study, the Bophelo Pele Male Circumcision project, conducted by the US’s research and development NGO Progresses and South Africa’s National Institute of Communicable Diseases. It was funded by the French National Agency for Research on AIDS and Viral Hepatitis. Business Day’s Tamar Kahn reports that the researchers offered free circumcision to boys and men over the age of 15. More than 20 000 of them complied.

The member is almost certain that the ethical requirements of clinical trial have been fulfilled to the letter, that the data collection for the research report has been done in the utmost integrity and that the researchers who formulated the hypotheses have been in no way influenced by popular misandry and the perception of men as testosterone-poisoned sexually promiscuous deviants for whom a cure has to be found, surgically if necessary.
What the report does not provide is a falsifiability protocol to test the methodology of the experiment. That, as Karl Popper, reminds us, would cast doubt on the validity of the experiment. Dr Dirk Taljaard of Progresses does note, however, that the study has not found any evidence that circumcised boys and men are adopting more risky sexual behavior.
But nothing is said about less risky sexual behavior. Specifically, the study does not account for any other behavioral changes at Orange Farm, such as the possibility of a response to an acutely raised awareness of HIV risks associated with sex following the circumcision project and other HIV campaigns over the three-year study period. As far as the member has been able to determine, Bophelo Pele data do not exist for abstention in their sample, an increase (or otherwise) in the use of condoms, or for the attrition of test subjects due to hospitalization, death or migration.
The member would have expected that, at the very least, the report would have included some references for comparison with HIV incidence and prevalence in societies where male circumcision is the cultural norm, even if the comparisons would be skewed by socio-economic conditions.
The researchers say in their report (http://www.malecircumcision.org/publications) that their next steps will be to create an example of what could be done to “roll out” male circumcision in southern Africa and to determine the feasibility of neonatal male circumcision. What the country needs, says Nathan Geffen, who is a member of the study’s scientific committee, is to make male circumcision a priority intervention in combating the spread of HIV/Aids. Business Day quotes him as saying that over the next two or three years, “we need to provide several million circumcisions.”


That leads the member to speculate about what possibly motivates our health authorities’ desperate grasping. Might it be the costs and capacity difficulties the state is experiencing with dispensing anti-retroviral drugs? The member’s (admittedly anecdotal) evidence of the state’s HIV project in rural areas is that the demand for ARVs is far greater than what the state could hope to supply. A doctor who practices exclusively among the poor in the Free State says that, based on the number of HIV-positive patients he sees every day, the projected the costs to the state each year in providing ARVs to everyone who qualified would be greater than the entire annual national budget.
On the weight of the evidence, the member has decided to build and patent a titanium chastity belt adapted for men. Let’s see the misanthropist nanny state get its scalpel past that lot.
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