California, where I’m spending the summer, efforts to ban circumcision are gaining ground. Devotees of sparing pain to children are persuaded that circumcision is a barbaric practice which infant boys should avoid. In sub-Saharan Africa, the credo — “no pain, no gain” — might explain why the best and the brightest in the region are promoting circumcision as never before. Circumcision undeniably reduces the risk of acquiring HIV, by at least as much as half; and circumcised men are less likely to pass along the virus as well. The double-bonus is now amply documented by scientific studies (stretching back to the mid-2000s) and explains why, all across Africa, communities with high levels of circumcised males show much lower incidences of the HIV infection than those where males do not have their foreskins removed.
These are early days for promoters of circumcision. Traditional ritual practices, such as those performed by the Bugisu of eastern Uganda, represent important coming-of-age experiences for rural males. “Graduates,” whom I interviewed several years ago during the Ugandan “cutting” season, invariably emphasize their personal bravery and — because the entire community witnesses their shearing in a raucous party atmosphere — there’s also the honor that their families receive from their sons’ acts of dignity (among the Bugisu, for instance, males are not to show any fear and should remain silent during the cutting). But the traditional justifications are not especially compelling for urbanized young African men who view the count the benefits of circumcision in medical, not spiritual, terms. Clever tactics are needed to convert the unshorn. One such instance, smartly described by Max Fisher in theatlantic.com, is the “Be Smart, Get Circumcised” campaign in Zimbabwe, built around a leading entertainer in the country.
The Bill and Melinda Gates Foundation is playing an important role in promoting circumcision in Africa, along with the U.S. government, through the President’s Emergency Plan for AIDS Relief (PEPFAR), initiated by President George W. Bush.
In California? A diverse coalition of people oppose the practice, and a risk in the rise of HIV transmission does not appear part of their public-health calculus.