AIDS & Circumcision
By Hwaa Irfan
HIV and AIDS
have challenged modern lifestyles, fundamental hygiene practices and
gender relations. As a result of the pandemic, U.S. Surgeon General
David Satcher, wishing to break the 'conspiracy of silence' surrounding
human sexuality, urged for a national debate. Facing a history of former
surgeon generals resigning or being dismissed after attempting to deal
with HIV and AIDS, Satcher produced a carefully worded report that
reflected America's wide and varied views on the subject.
The report asks for open discussion on abstinence, safer sex practices
and contraceptives in schools (Reuters Health, p.1, 2). Elsewhere, a
statement was issued challenging even the idea of contraceptives, a
topic that arose at the end of a 6-day Southern African Catholic
Bishops' Conference in Pretoria. The bishops felt that, "Condoms may
even be one of the main reasons for the spread of HIV/AIDS. Apart from
the possibility of condoms being faulty or wrongly used, they contribute
to the breaking down of self-control and mutual trust" (RNS, p.1). They
cited a different reason for the spread of HIV and AIDS - the decline in
Allah (swt) gave us guidelines in the Qur'an that play important roles
in all aspects of our lives and health practices. The Qur'an even
addressed the spreading of viruses. While HIV and AIDS have become the
leading cause of death among women aged 20 - 40 in Europe, sub-Saharan
Africa and North America (About, p.1), the world's HIV and AIDS drug
industry continues to fail at finding a cure. Meanwhile, drug resistant
viruses have increased and debates continue over the health benefits of
This, however, does not change the findings of John and Pat Caldwell,
who tell a frightening story. With over 30 years experience in family
dynamics and fertility control in Sub-Saharan Africa, the Caldwells
began working on sexually transmitted diseases there in the 1970s,
taking all existing theories into account. The most popular theory is
that the disease itself originated there, however, this theory is
undermined by the fact that AIDS cases occurred in hospitals in Uganda
and Rwanda at the same time as they did in the West. The only common
factor in the spread of AIDS in Africa that the Caldwells found was the
issue of male circumcision, which was generally unpracticed in the heart
of the AIDS Belt - Central African Republic, Southern Sudan, Uganda,
Kenya, Rwanda, Burundi, Tanzania, Zambia, Malawi, Zimbabwe and Botswana
In 1989, a joint Canadian-Kenyan medical research team at Kenyatta
Medical School in Nairobi reported that during the previous year, the
AIDS rate was higher among Luo migrants from Western Kenya than among
the Kikuyu of Central Kenya. The uncircumcised Luo men were more likely
to have syphilis or chancroids - a sexually transmitted disease
characterized by soft sores in the private area. They also had an
unexpected elevated risk of contracting HIV (Caldwell, p.41).
An American team, led by John Bongaarts of the Population Council, also
found that the regions across sub-Saharan Africa with high levels of HIV
infection among local peoples correspond remarkably with the areas where
men were not circumcised. The research drew upon statistics from the
World Health Organization (Caldwell, p.44).
However, uncircumcised men in Tanzania did not need to wait for
agreement among the researchers to come to their own conclusions. Based
on their own observations of their community and of neighboring
communities, they requested circumcision for themselves (Caldwell p.46).
Epidemiological evidence points to the inner surface of the foreskin,
which contains Langerhans' cells that act as HIV receptors - a likely
point of entry for uncircumcised men. A keratinized stratified squamous
(scaly) epthelium (membranous tissue) covers the penile shaft and outer
surface of the foreskin. This provides a protective barrier against HIV
infection. The inner mucosal (mucus) surface of the foreskin is not
keratinized and is rich in Langerhans' cells. During intimate relations,
the whole inner surface of the foreskin is exposed to vaginal
secretions, providing an increased area for HIV transmission.
Forty studies provide evidence that male circumcision protects against
all sexually transmitted diseases, and that circumcised men are 2-8
times less likely to become infected. Robert Szabo concludes that
circumcision, as practiced by Muslims, would be the most immediately
effective intervention for reducing HIV transmission since it is done
before men are sexually active (Szabo, p1-3). Epidemiologist Robert
Baily of the University of Illinois, Chicago, said, "No one wants to be
the first to come out with a statement in support of male circumcision."
In the U.S. and Europe there are big anti-circumcision movements now, so
people don't want to promote something in Africa that is discouraged
here…" (Shillinger, p.2).
Circumcised men come from communities that place a deep religio-cultural
significance on this particular hygiene practice; which doesn't
necessarily apply to those who do not (Shillinger, p.1). The majority of
Muslims believe that male circumcision is obligatory and it is one of
the five acts of cleanliness recorded in Sahih Muslim, Sahih Bukhari,
Musnad Ahmed and Sunnah at-Tirmidhi (Persaud, p.1).
There are also additional obligations of hygiene and social conduct
within marriage. However, this does not mean that Muslims are immune to
HIV and AIDS since Islamic practices have become compromised by other
factors. Currently, 50% of Moroccan women who have AIDS have been
infected by their husbands (Clinton, p.3).
For now at least, the safest path to follow is one of cleanliness and
purity, which modern science has confirmed.
Caldwell, John & Pat. "The African AIDS Epidemic." Scientific America
274: 3 (1996) 40-46.
Naqvi, Siki. 'Ali, M. "A Manual of Islamic Beliefs and Practice." The
Muhammadi Trust of Great Britain & N. Ireland. 1991.
Persaud, T. and Ahmed Mustafa, A.
"Islamic Rules for Male Circumcision." The First International
Conference for the Scientific Aspects of the Qur'an and Sunnah in
Islamabad, Pakistan. Islamzine.com. 08/14/01.
Reuters Health. "Surgeon General Calls for Open National Dialog on
Sexuality." Reuters Medical News. 06/28/01.
Reuters Health. "Drug Resistant HIV Spreading in UK." Reuters Medical
RNS. "South African Bishops Condemn Condoms as 'Immoral and Misguided."
Religious News Service. 07/30/01. Beliefnet.com 08/06/01.
"Male Circumcision Cited for Differing HIV Rates Among Africans."
Antipas.org 05/11/99. 1-3.
"How Does Male Circumcision Protect Against HIV Infection." British
Medical Journal. 06/10/00.