Katarina Jungar and Elina Oinas

The Weiss, Quigley and Hayes (2000) review on male circumcision and HIV prevalence restricts itself to female—male transmission in Sub-Saharan Africa (Weiss et al. 2000), with the explanation that in Sub-Saharan Africa heterosexual transmission is the predominant mode of transmission. They ignore the figures that the primary mode of heterosexual transmission is male to female transmis­sion. The research agenda around male circumcision is focused solely on protect­ing the man from becoming infected.

The research reports state that “HIV transmission to the female partner was not significantly reduced if the male was circumcised” (Quinn et al. 2000:924) or that “the overall effect of circumcision on HIV transmission from infected men to their HIV-negative partners was modest and not statistically significant.” (Gray et al. 2000:2380). In other words, women become equally infected by HIV-posi­tive men regardless of whether they are circumcised or not. We argue that when making the gender dimension of heterosexual transmission invisible and at the same time focusing on the protection of men, gendered power relations are in fact strengthened.

Our first concern is the question of how HIV prevention research can still work from a hypothesis that ignores women. Even if the discourse of biological reductionism was accepted as a starting point for discussion, the issue of women getting infected should be the central one as women, especially young girls, are claimed to be physiologically more vulnerable to HIV infection than men due to the composition of female sexual organs (Gavey and McPhillips 1997). Especially young women’s tissues are argued to be more easily penetrable by the virus even in sexual acts with their consent, not to mention acts of violence where ruptured tissues are a specific risk factor for the woman rather than the man (Gorna 1996).

Second, what these studies do not account for is that if the ‘news’ of men be­ing protected by circumcision spreads, HIV transmission to women may increase significantly. If circumcision were seen as a way of prevention it would probably decrease women’s possibility to negotiate safe sex as the whole discourse is built upon male power in heterosexual practices. The real risk for women is that the medical ‘knowledge’ of the protective effects of male circumcision may lead to neglect of other prevention measures. This worry is not unwarranted since the media seems eager to publish any news on progress in HIV prevention, and sci­entific news must be simplified in popular media.

On the basis of statements in many pro-circumcision texts, the idea that male circumcision may protect men from HIV has already become known and influ­ences lay people. Szabo and Short state that “it is pleasing to note that organiza­tions are now beginning to give serious consideration to the policy implications arising from the protective effect of male circumcision against HIV infection” (Szabo and Short 2000b:1467). An article on a Tanzanian study reports that male circumcision has become popular among educated, urban men regardless of their ethnic or religious background (Urassa et al. 1997). Halperin and Bailey present the following: