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Mass Circumcision and Moral Hazard

Posted Jan 18 2011 3:33am

In Swaziland , a nationwide campaign is under way to circumcise 160,000 males by the end of this year .  Not 160,000 male babies, 160,000 adult males.  In a country with less than 1.5 million people, this is a huge undertaking.

Why would the government of Swaziland promote adult circumcision so strongly?  Here’s the answer:

“…a randomized controlled trial in South Africa (later confirmed by studies in Uganda and Kenya) found that circumcised men are as much as 60 percent less likely to contract HIV through heterosexual sex. Scientists do not yet know exactly why, but the study was so convincing that it was stopped after 18 months, because preventing the uncircumcised control group from getting the procedure would have been unethical.”

“Currently, 20 percent of Swaziland’s population are HIV positive…Nearly half of women ages 25 to 29 and men 35 to 39 are infected.”  Thus, circumcision is seen as a way to reduce the spread of HIV.

However, could circumcision actually increase the prevalence of HIV in the country? This may be the case if moral hazard strikes.

Moral hazard would occur if young Swazi males now overestimate their protection against HIV and these men become more promiscuous.  In fact, after circumcision “Some of the men have the misconception that they’ll be 100 percent safe.”  Fortunately, NGOs are providing counseling before and after the procedure to educate the Swazi men on the post-circumcision risk and the need to use condoms.  For the sake of their future, let’s home the young men listen.

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