At least 40 per cent of the male population in Rwanda have so far been circumcised but the Rwanda Biomedical Centre (RBC) is pushing to see that the number rises to 70 per cent, the HIV Division Manager at Rwanda Biomedical Centre (RBC), Dr. Gallican Rwibasira has said.

Rwibasira says that male circumcision is one of the areas that are very important in reducing the risk of contracting HIV.

"This is an important area because circumcision protects men from the risk of contracting HIV by around 60 per cent. However, this percentage is very effective in a country where you have around 70 per cent of males circumcised. We are now at 40 percent,” he said.

Covid-19 challenges

Rwibasira explained that the target was to have at least 400,000 males aged 15-19 circumcised every year but challenges posed by Covid-19 have interrupted these plans.

"Majority of this population is in schools. It’s normally a mass campaign where we talk to these young men and then use the nearest health facility to test and circumcise them, but of course with Covid-19, mass exercises have been put on hold,” he said.

He added that by the time the pandemic hit, this exercise had seen numbers improve from 346,000 people in July 2019 to 401,987 in June 2020.

However, he said that the interruptions in this exercise are temporary and every effort is being invested in catching up.

Call on parents

Rwibasira called on parents to have their children circumcised at an early age.

"Some people may challenge you and ask you why you are circumcising a six-year-old, after all, it’s about HIV, but we must admit that they are getting sexually active at a young age and its best that you prepare for any risk that may arise at some point as early as possible," he said.

He reminded that with advancement in technology and medicine, circumcision has become easier where babies feel no pain and don’t even experience any bleeding.

In 2013, the ministry of health rolled out the non-surgical male circumcision, medically referred to as PrePex.

PrePex is in form of a ring. It enables circumcision to be performed without surgery or any blood loss, by nurses, who don’t need extensive training to use the apparatus.

The PrePex device is made of three components. The first is the rigid inner ring that is applied inside the foreskin while the elastic ring is applied on top of the foreskin to cut off the blood flow to the foreskin.

The third item is used to cover the forehead of a male organ not to be contaminated. Medics say the dead foreskin and the device are removed after seven days.

Reluctance among adults

In a recent interview, the RBC Manager in Charge of Male Circumcision, Arlette Nikokeza, pointed out that men above 20 are the most reluctant to undergo the procedure yet science shows that circumcision reduces the chance of catching HIV through sexual intercourse by 60 per cent.

"Circumcision is not something popular in Rwandan culture. It’s still viewed as something for children. 70 per cent of the people who attend the programme are below the age of 20,” she said.

The 2010 and 2015 demographic and health survey shows an increase of male circumcision prevalence from 13 per cent in 2010 to 29.6 percent in 2015.