In all the articles male circumcision is being promoted only to non-Western countries. The first question we need to ask is why male circumcision is researched and promoted as a method to prevent HIV transmission in the South, but not in Europe or the United States? How can medical researchers argue that male circumcision can offer some immediate protection against the spread of the disease but not promote circumcision in the West? Even the most enthusiastic pro-circumcision researchers keep the ‘developed’ world out of the discussion:
Other than recommending that male circumcision should be seriously considered as an additional means of preventing HIV in all countries with a high prevalence of infection, we have avoided all discussion about the relative advantages and disadvantages of neonatal male circumcision as a routine procedure in developed countries, where the prevalence of HIV infection is low. We do not intent to enter that debate, where objectivity is hard to find (Szabo and Short 2000b:1469).
Nowhere in the articles is the construction of this clear cut “difference” between the developed countries and Africa explained however strongly it is assumed to exist. It seems clear that this unexplained “difference” is the bottom line of the whole argumentation for male circumcision. HIV/AIDS in Africa is something special, an issue different from HIV/AIDS in the West. Imagery of a dark continent on the brink of disaster, as pointed out by Patton (1997:391), is invoked, for example: “The heterosexual spread of HIV-1 in some regions of Sub-Saharan Africa has been explosive” (Tyndall et al. 1996:449). Africa is constructed as a lost continent where people are dying anyway, which is why different preventive measures must be implemented and can be afforded. Africa being the dark continent, Africans cannot afford “opinions” the way the West can in the quote above.
The argument of Africa as ‘different’ is intertwined with that of Africans as different. The underlying assumption is that promotion of condoms and changes in sexual behavior—elsewhere seen as the primary mode of HIV protection—do
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not solve the problem of ‘African AIDS’. Male circumcision promoters do not question condoms as the primary measure of HIV/AIDS prevention, but they argue that in Africa condoms do not suffice. Condoms cannot be enough in Africa because Africans will not use condoms, or cannot use them properly. Access to condoms is not even always accounted for in the texts that seek explanations for regional differences in infection rates: Although condoms must remain the first choice for preventing the sexual transmission of HIV, they are often not used consistently or correctly, they may break during use, and there may be strong cultural and aesthetic objections to using them (Szabo and Short 2000a:1593). In their article, published in Clinical Infectious Diseases, Tyndall et al. write: However, in the view of the rapid spread of HIV-1 and the lack off effective prevention strategies currently available, circumcision indeed may offer one of the few effective means of slowing the spread of HIV-1 in some countries (Tyndall et al. 1996:453, emphasis ours). Why would not condoms be a currently available, effective means of prevention of HIV/AIDS in Africa? Why is antiretroviral therapy—that has made a huge difference in the West—not even mentioned as a (at least partial) remedy for Africa? Our interpretation is that in these texts Africa is represented as poor and hopeless, and Africans themselves cannot be trusted to bring about a change. Therefore surgical measures directly on their bodies1 are most effective. In this discourse the black penis that needs to be altered is an appropriate means of addressing a mystical catastrophe in Africa. Following Patton’s argument, it should be no surprise that male circumcision as HIV prevention resonates with Western fantasies about African sexuality and, unlike more mundane prevention campaigns actually taking place in Africa, attracts the interest of the media in the West. “In Western eyes, Africa’s problems can only be solved through civilizing forces—or in the romantic version, through a withdrawal from civilisation and a return to pristine ‘tribal ways’” (Patton 1997:391; cf. Treichler 1999:99). The medical promotion of male circumcision is a graphic illustration of what ‘tribal ways’ can mean. In several texts it is suggested that male circumcision is, anyway, already a part of African culture, at least in many areas. Male circumcision may be a more ‘natural’ method of prevention to Africans than the plastic device, a condom that is a Western technological invention and difficult to use for Africans. |
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