Civil Society Report-back on dialogue on Male Circumcision: Implications for Women

ENSURING PREVENTION STRATEGIES WORK FOR WOMEN
Statement on medical male circumcision for HIV prevention by women's health activists

We, mainly women from sub-Saharan Africa, the epicentre of the HIV/Aids epidemic gathered in Mombasa, Kenya note that of all HIV infections in sub-Saharan Africa, 60% affect women. As such, any response Should have women as central to any prevention, care and treatment response to HIV and Aids.

We need prevention and treatment programmes that work for women and thus accept male circumcision as part of a comprehensive package of prevention, care and treatment. We ask that resources not be diverted from prevention and treatment efforts that work (condoms, female condoms, diagnosis and treatment of sexually transmitted infections and HAART and or treatment) and that these be continued to scale up.

There is also a need to continue resource allocation in the integration of HIV/Aids and sexual and reproductive health and rights programming, as well as around women's empowerment (or gender equality). We also note that there is a need to craft meaningful participation of women and positive women in research, policy development, and programme planning and implementation efforts.

Having reviewed the research and evidence from the three RCTs we note that there is an estimated 60% prevention of transmission to heterosexual men. There is no conclusive evidence to demonstrate any direct benefit for women. Modelling studies suggest indirect protection will eventually accrue to women but that in the short term incmased feminisation of the epidemic is likely.

Proven prevention methods like the female condom for women continue to be under-resourced. Expanded resources are also needed for research to identify additional biomedical prevention strategies like microbicides, pre-exposure prophylaxis and vaccines, as well as structural and behavioral interventions that will reduce women's risk.