The Social Penis. Traditional Male Circumcision and Initiation in Southern Africa, 1800-2000: A Literature Review
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Since pre-colonial times, TMC has been practiced in Muslim and African communities in Africa as part of initiation into manhood. In this paper we therefore refer also to the broader practice of traditional male circumcision and initiation as TMCI. In the 1990s, differences in HIV prevalence across Africa were linked to patterns of traditional male circumcision (TMC). After some randomised clinical trials conducted in the early 2000s, it was established that male circumcision (MC) was linked to significantly reduced HIV risk (Siegfried et al. 2009). However, the notion that MC should be 'rolled out‘ as a public health intervention to protect against the transmission of HIV and other sexually transmitted diseases has some elicited controversy in public health and human rights literature (e.g. Denniston et al 2001), although over time the acceptability of MC as an intervention has grown (Wamai et al, 2011). UNAIDS and the WHO developed operational guidelines for scaling up MC but programmatic development has been slow, largely because of sub-optimal funding (Wamai et al, 2011: 6-10). As of the end of 2010, 555,202 MCs were performed as part of the MC rollout in Sub-Saharan Africa, of which over threequarters took place in 2010. This suggests that there is momentum behind this policy but that with less than 2.7% of the estimated 20.8 million men targeted for circumcision being reached, progress is slow indeed (Wamai et al, 2011).