Western organizations have big, big plans for the penises of millions of African men. They are to be clipped, and in short order. In Tanzania alone there is a plan to circumcise 2.8 million men in the next five years. What those men decide to do with their newly trimmed penises, after the mobile circumcision unit is just a painful memory, will ultimately determine whether or not these campaigns are effective at reducing HIV/AIDs rates in Africa.
There are two facts about HIV that are difficult to reconcile. The first fact is that the transmission rate of the disease is extremely low; the risk of being infected from an person who has the disease through vaginal intercourse is about one in a thousand or 8-12% per-partner-year.* The second fact is that the disease has an extremely high prevalence among heterosexual women in Sub-Saharan Africa; 40% of pregnant women in Botswana and 25% in South Africa are infected with the disease.
British firms have sunk millions into new technology which will enable people to test themselves for Sexually Transmitted Infections (STIs) using their mobile phones and a chip they purchase for less than $2. The motivation behind the initiative is to encourage STI testing with a goal to reducing the nation’s high STI transmission rates among the younger population. A worthwhile goal, but what happens if the test leads to riskier sex? If it does, then the investors will have overestimated the new technologies benefit to society.
In 2008, 41,269 people in the U.S. were diagnosed with HIV, an increase of 8% from only three years earlier. Known infections make up only 75% of total infections, leaving 25% of HIV infected people unaware that they have the disease. The transmission of HIV by people who are unaware is estimated to be at least three and half times the rate of the transmission of HIV by people who are aware of their infection status.*
In light of yesterday’s decision by the Federal District Court in San Francisco to strike down a ban on same-sex marriage in California, why not ask the question: How does the legalization of gay marriage in a particular geographical region affect the HIV rate there?