Circumcision diary

Kennedy feels the pain as the needle goes in

Around one million Zambians - which includes 17% of the adult population - are believed to have HIV/Aids, a fact marked by World Aids Day on Saturday.

After experts from the United Nations backed male circumcision as a way of reducing the chances of getting HIV, the BBC's reporter in Zambia's capital Lusaka, Kennedy Gondwe, decided to undergo the procedure himself.

It should be noted that this was Mr Gondwe's personal decision, not the BBC's, and that circumcision does not give immunity to HIV/Aids.

HIV TEST

Today is a very special day for me. I've just woken up and am going for an HIV test prior to my circumcision.

Trials show circumcision halves HIV infection in heterosexual men

I have been thinking about being circumcised from the time that I was young, but unfortunately I have not had time to do it.

I have always wanted to be circumcised as a way of fighting the HIV/Aids scourge.

After reading a lot about circumcision, I am convinced that it is indeed a preventative measure for HIV/Aids.

I know already that the chances of me being HIV-negative are very high, because I go for these tests three or four times a year.

I have not gone for one this year, but I know I have not indulged in any risky behaviour, so I am not particularly nervous about the result, but I do wonder what people are going to make of my story.

One thought that is bothering me is that I don't know if I will be able to drive for the next day or two because of the pain that will be between my legs.

But that is the choice I have had to make.

The test itself is a little painful - I could feel it.

My results are ready soon after the test. They are negative, as expected.

THE OPERATION

In the male circumcision room, there are two beds. These are what men rest on after the operation until they are energetic enough to go back home.

With me is Boniface Chikumbe, the male circumcision provider.

I am very amazed and impressed at how quickly I find myself recovering

"The details of the procedure are quite elaborate," he tells me.

"One of the first stages is to prepare the surface we are going to work on by cleaning it with an antiseptic solution.

"After that we are going to mark the exact area where we are cut off the foreskin. That will be preceded by giving you a local anaesthetic.

"After that we will cut off the foreskin, stitch together the cut areas, and bandage you to prevent any bleeding."

I am taken through to the theatre and lie down on a couch. The anaesthetic needle is inserted into the base of my penis.

The needle hurts. But when they cut, I do not feel a thing.

I see my foreskin. It looks ugly, with a lot of blood all over it.

AFTERWARDS

Thirty minutes later, they are done, and I am sent to the recovery room.

I ask Boniface how I should look after the wound.

Kennedy's operation was performed without general anaesthetic

"When you get home, look out for any incidences of blood, of swelling or of pain," he says.

Walking to the car, I feel strong enough to drive home.

I am very amazed and impressed at how quickly I find myself recovering as I drive back.

The only difference is that my foreskin has gone forever.

But it is something that I had prepared myself for, and I have no regrets at all.

Later, on BBC World Service's Outlook programme, Dr Tim Farley of the World Health Organisation explained that the reason circumcised men have a lower rate of HIV infection is that the tissue on the inside of the foreskin is very fragile, and therefore vulnerable to minor tears or abrasions during sex.

It is through these tears that HIV can get into the blood.

"Removing this part of the skin therefore reduces the risk of infection quite considerably," Dr Farley said.

However, he also stressed that circumcised men are not immune to the virus.

"They have to take other precautions in addition to circumcision in order to avoid HIV infection."

These include wearing condoms, reducing the number of sexual partners, and ensuring prompt and effective treatment is sought for any sexual transmitted infections, he added.

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Here are a selection of comments sent in by BBC news website users about this story.

Well done Kennedy.I have read a lot about circumcision and me too am sure that it can help to prevent the transmission of HIV.You have inspired me. Am next.
Chongo Mulenga, Lusaka, Zambia

Well, HIV is a very difficult ailment, that is why any viable approach to minimise its spread is most welcome no matter how painful !
Maxwell Milembo Chilinda, Lusaka, Zambia

Yes. This initiative will certainly help. UNICEF is committed to supporting good advocacy and accurate communications around male circumcision for HIV prevention. We are very pleased with the interest that BBC is taking in this story, and of the initiative of Kennedy in Zambia! This procedure is available today, now, costs less than $50 a time, and it will reduce infection risks in men (and ultimately in women) by at least 60%. We continue to hope for a vaginal microbicide, and a vaccine, but the recent news on both of these is not good, and we may not have much good news on these even in ten years time. All men in countries where HIV prevalence is high, and where male circumcision is rare, should be encouraged to consider the procedure. Parents should be encouraged to consider having their infants boys circumcised shortly after birth (a procedure much simpler than Kennedy's).
David Alnwick, senior Unicef adviser, HIV and AIDS, Nairobi, Kenya

I am happy that this reporter form Zambia took this decision. I must admit when I learnt men are not circumcised in some parts of the world I was totally suprised and wandered how they will be enjoying sex with the skin there. I think more men should take this up and see the difference. I believe it is a must for men as it will make them more hygenic. I believe the research by scientist is totally true and HIV would be less as they would be cleaner and what more enjoy sex more. This is the reason why more south and east Africans are going for West African Men.
Jarieu, Kabala, Sierra Leone

I don't quite know how circumcision helps to reduce the risk of HIV/AIDS infection, but am convinced that Kennedy did a lot of reading on the subject before he made the decision and I must admit I admire his decision to share his experience with the world. It's piqued my interest to do a bit of research myself, here in Ghana.
nana yaa brago, accra, ghana

Whether circumcission reduces infection is debatable but one thing is for sure having multiple sexual partners increases the risks of contracting HIV/AIDS.I would encourage all uncircumsised men to under go this exercise to maintain body hygiene.
Lenard Wasabato, Mombasa Kenya