Varieties of male circumcision - A study from Kenya

Background: Because male circumcision has been linked to a lower risk of HI V infection, it is advocated tentatively as a possible preventive intervent ion. Most studies, however, have relied on men's self-reports of their circ umcision status. Goal: To document varied techniques of male circumcision in one area of Ken ya and the visible results. Study Design: Researchers interviewed men who had performed or undergone va rious forms of circumcision. They also did genital observations on a subsam ple of respondents. Results: All the men reported undergoing circumcision during adolescence, a nd most were able to tell which technique was used. According to the circum cisers, in type A, approximately 4 cm of the prepuce is removed; in type B, 1 to 2 cm of the prepuce and some of its inner surface are removed. Types A and B result in the same genital appearance. In type C, 1 to 2 cm of the prepuce and some of the inner surface are removed. The remaining prepuce is slit and suspended below the penile shaft. Conclusions: Asking a man "Are you circumcised?" is not sufficient. Classif ying his circumcision status requires both a genital examination and an und erstanding of the precise local surgical techniques used. Even in a small g eographic area, considerable variety may exist in the techniques of cutting , removing, altering, or leaving different portions of the foreskin. Each v ariation may affect the transmission of HIV and other infections.