HIV prevention: Making male circumcision the 'right' tool for the job

Glob Public Health. 2015;10(5-6):552-72. doi: 10.1080/17441692.2014.903428. Epub 2014 Apr 10.

Abstract

In recent years, HIV/AIDS programming has been transformed by an ostensibly 'new' procedure: male circumcision. This article examines the rise of male circumcision as the 'right' HIV prevention tool. Treating this controversial topic as a 'matter of concern' rather than a 'matter of fact', I examine the reasons why male circumcision came to be seen as a partial solution to the problem of HIV transmission in the twenty-first century and to what effect. Grounded in a close reading of the primary literature, I suggest that the embrace of male circumcision in HIV prevention must be understood in relation to three factors: (1) the rise of evidence-based medicine as the dominant paradigm for conceptualising medical knowledge, (2) the fraught politics of HIV/AIDS research and funding, which made the possibility of a biomedical intervention attractive and (3) underlying assumptions about the nature of African 'culture' and 'sexuality'. I conclude by stressing the need to expand the parameters of the debate beyond the current polarised landscape, which presents us with a problematic either/or scenario regarding the efficacy of male circumcision.

Keywords: HIV prevention; controversy; male circumcision; scientific facts; social studies of science.

Publication types

  • Review

MeSH terms

  • Circumcision, Male*
  • Global Health*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Health Policy
  • Humans
  • Male
  • Sexually Transmitted Diseases, Viral / prevention & control*
  • Sexually Transmitted Diseases, Viral / transmission