Male circumcision involves the removal of some or all of the foreskin of the penis. Male circumcision is common in cultures throughout the world and has been shown to decrease the risk of HIV infection, in part because of physiological differences that reduce the susceptibility to HIV infection among circumcised men. (Auvert et al., 2005; NIAID,2006).
Male circumcision places men at greater risk of being infected with HIV/AIDS because the procedure in Tanzania is usually performed on groups of children in non-sterile environments. If one member in the group is HIV positive, there is a high chance that others may become infected. On the other hand, some researchers argue that male circumcision has a protective effect against the spread of
HIV and other sexually transmitted infections (Agot et al., 2004).
The association of male circumcision and reduced HIV prevalence has been reported in a number of observational studies. Three randomized controlled trials conducted in South Africa and the neighbouring countries of Kenya and Uganda on male circumcision and HIV transmission have demonstrated a 50-60% decrease in the risk of acquiring HIV infection among men who underwent circumcision during the trial compared to those who were not circumcised. Therefore there is compelling global evidence that safe male circumcision should be one of the public health interventions to reduce the transmission of HIV especially in countries with high HIV and AIDS burden and low male circumcision prevalence. Furthermore, other studies have demonstrated a number of other health benefits of male circumcision including reduction of: RTIs in children, Genital Ulcer Disease, cervical and penile carcinoma. Reported social benefits include increased sexual pleasure in both partners and personal hygiene. (HSHS 2008-2012)
The practice of male circumcision in Tanzania is often for religious and cultural reasons rather than for the purpose of HIV prevention. Modernization and peer pressure have been documented as other reasons for male circumcision. Medical indications for male circumcision include phimosis and paraphimosis. In most regions and districts this is done in health facilities but in some districts traditional male circumcision is still being practiced. In Tanzania, male circumcision is commonly practiced in many communities and the overall prevalence is about 70% (THIS 2003/04).
Though THIS 2003/04 findings indicated that the difference between HIV prevalence among circumcised and uncircumcised men was not significant (7% versus 6%), ecological comparison from the same study show a pattern of lower HIV prevalence in circumcising than in non-circumcising belts. For example the high HIV-prevalence regions of Mbeya and Iringa have relatively low male circumcision rates (34.4% and 37.7% respectively) compared to Manyara with male circumcision rate of above 80%.and HIV prevalence of 2%. (HSHS 2008-2012).
According to THMIS 2007/08, men who have been circumcised are less likely to be HIV positive than those who are not circumcised (4 and 6 percent, respectively).