Video: Kenyan males line up for circumcision

Editor's note: Africa has the world's largest number of HIV infections and AIDS cases. Across the continent the disease is being battled with public education and antiretroviral drugs. A new additional strategy is male circumcision. Several tests show that circumcised men have substantially reduced risks of contracting HIV. In response, several campaigns have been launched to circumcise men.

GlobalPost has investigated this public health effort in eastern and southern Africa. The series starts in Kenya in the fishing villages by Lake Victoria and includes this video of a circumcision (below). Also, a Kenyan doctor describes his work running a circumcision clinic, health writer Mercedes Sayagues gives her controversial opinion on the issue and a South African doctor describes the circumcision campaign in several southern African countries.

KATITO, Kenya — The men snickered awkwardly as they discussed their sex lives.

At first, they dutifully recited talking points — “I want to be protected from HIV” — like school children trying to say exactly what the teacher wanted to hear.

But as they loosened up, their questions became more pointed: How much will it hurt? Will I become impotent? Will I become better at sex? Will I be more sensitive? Will girls like me more?

It was male circumcision day in this village in southwestern Kenya.

The weekly clinic of medical professionals is part of an internationally funded fight against HIV and AIDS. Research in Kenya, Uganda and South Africa has shown that circumcision can reduce a man’s chances of infection by as much as 60 percent during heterosexual sex.

Kenyan doctors perform a circumcision. (Adam Jadhav/GlobalPost)

For a year, the Nyanza Reproductive Health Society has operated the Katito clinic here in Nyanza province. Each week, as many as two dozen men and boys as young as 10 shuffle their feet and kick the dust as they wait in a courtyard also occupied by goats.

The region is home to Kenya's portion of picturesque Lake Victoria as well as Kisumu, the country's third-largest city. It is also Kenya’s HIV hotbed, where more than one in seven people between the ages of 15 and 64 are infected, more than double the national rate.

Five at a time crowd into a small room to speak first with counselor Japheth Ouko, who explains the circumcision procedure, the risks and the proper post-op care. Using a brown wooden model of male genitalia as a prop, he occasionally waves it like a pointer. His details elicit some squirming and lip biting.

Ouko grills the men to think about why they are there: Are you afraid? Do you understand that this is not a fail-safe prevention?

“You must practice safe sex, protected sex,” Ouko says. “Circumcision is not a permanent condom.”

Health officials worry that men will mistake circumcision for foolproof protection against HIV/AIDS, as some rumor has promised. Ouko cautions them against thinking of the procedure as a cure. He tries to keep the conversation serious, his tone grave, lecturing that circumcision’s protective benefits are nullified if it leads to more risky behavior.

Ouko clarifies another important point: So far, circumcision offers no reduction in HIV/AIDS transmission during homosexual sex. Nor does it protect women from men infected with the virus.