MEDICAL MALE CIRCUMCISION (MMC)
Medical male circumcision (MMC) is a safe and effective way to bring down your risk of HIV infection. Learning more about the benefits and disadvantages of circumcision can help you make the call to get circumcised. Men living with HIV should know that getting circumcised has benefits for them too! Many men have doubts or questions about who can go for circumcision and whether they can circumcise all year round, we have the answers. If you’ve made the decision to get circumcised check out the Brothers Guide to Getting Circumcised, it has all the information you need, from making a booking to dealing with healing. If you’ve already circumcised, we have information on caring for your wound after circumcision. Boys and teens can go for MMC from ten-years-old. You can get information on caring for your son’s wound here. If you were circumcised for religious or cultural reasons you might have a partial circumcision, click here for our section that shows the difference between circumcised, uncircumcised and partially circumcised.
Remember, circumcision is just one tool in your HIV prevention toolbox that needs to be used along with other tools like condoms and sticking to one partner, in order to give you maximum protection from HIV, STIs and unplanned pregnancy.
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Medical male circumcision (MMC) is the surgical removal of the thin layer of skin that covers the head of the penis. Removing this skin, called the foreskin, fully exposes the head of the penis.
Getting circumcision is the right thing to do for your health and the health of your partner and loved ones because it has many health benefits:
- Reduces your risk of contracting HIV if you are an HIV-negative man
- Reduces your risk of some sexually transmitted diseases/sexually
transmitted infections (STIs) whether you are HIV-negative or HIV-positive - Reduces your partner’s risk of cervical cancer
- Makes the penis easier to clean
- Lowers your risk of penile cancer
Circumcision doesn’t fully protect you from HIV – it only lowers your risk of contracting the virus. You still need to use a condom correctly and consistently to make sure you are protected even if you are circumcised.
MMC BENEFITS & DISADVANTAGES
Although there are some slight disadvantages to medical male circumcision, they are outweighed by the advantages or benefits:
| BENEFITS |
|---|
| Reduces the risk of HIV by decreasing the risk of tiny tears and bruises which can be an entry point for HIV |
| Also lowers the risk of contracting HIV by removing the foreskin, which has cells that are sensitive to HIV infection |
| Reduces the risk of contracting sexually transmitted diseases/sexually transmitted infections (STIs) |
| Lowers the risk of penile cancer |
| Improved hygiene because the head of the penis is easier to clean |
| Reduces your partner’s risk of cervical cancer and STIs |
| Minimal downtime – You can go back to work on the day of your circumcision or the next day. You will only need to take a few days off at most. The health-care facility will provide you with medical certificate. |
| MMC is done at hygienic medical facilities. Your circumcision is done safely, quickly and to the highest standards. Healthcare workers can also help you through the healing process. |
| DISADVANTAGES |
|---|
| You might feel slight pain and discomfort during the procedure but this is controlled with local anaesthetic |
| You might experience some discomfort when the local anaesthetic wears off after the procedure but this is easily managed with the painkillers you are given at the healthcare facility |
| You cannot have sex or mastrubate during the 6-week circumcision healing process but this is a small price to pay for the big benefits of circumcision. |
| You may have unexpected erections during the circumcision healing process. These cause only mild discomfort. These can be managed. |
| You will need to take a small break from running, soccer or gym to avoid damaging your wound but the good news is you’ll be ready to get back into the game 2 weeks after your circumcision. |
| MMC does not reduce your risk of contracting HIV if you have penetrative anal sex with a man or a woman. |
| Minimal downtime – You can go back to work on the day of your circumcision or the next day. You will only need to take a few days off at most. The health-care facility will provide you with medical certificate. |
| MMC is done at hygienic medical facilities. Your circumcision is done safely, quickly and to the highest standards. Healthcare workers can also help you through the healing process. |
WHO CAN GO FOR CIRCUMCISION?
You can get circumcised as an adult. Men of any age can circumcise to take control of their health, to protect themselves, their loved ones and their partners. You are never too old to make the right choice!
Some religious groups circumcise boys soon after birth, and some cultures such as the amaXhosa circumcise young men as part of an initiation process that marks the journey from boyhood to manhood. But if you weren’t circumcised as a baby, you can still circumcise later in life. You can still benefit from this very effective intervention of preventing new HIV infections in boys and men.
If you were circumcised for religious or cultural reasons, your circumcision may only be a partial circumcision and not a full circumcision. The entire foreskin must be removed in order to enjoy the full health advantages of circumcision. If you are unsure about whether you are uncircumcised, partially circumcised or fully circumcised go to your nearest health facility for assistance.
Public health facilities do not circumcise baby boys but will circumcise boys who are 10-years-old and older. Boys younger than 10 can only be circumcised if there is a specific medical problem. Boys and young men under the age of 18 must have permission from their parent/s or guardian/s to be circumcised.
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WHEN IS THE RIGHT TIME TO CIRCUMCISE?
There is no right or wrong time to get medical male circumcision. You can circumcise all year round. Summer can be the best time to circumcise because there are fewer people in the clinic. The circumcision healing process will take the same amount of time in Winter or Summer.
IS MEDICAL MALE CIRCUMCISION SAFE?
Medical male circumcision is FREE as part of a programme run by the provincial and national Departments of Health supported by the American Government through USAID and the Centre for Disease Control. MMC is provided at special clinics, hospitals and some private doctors who have joined the programme.
Because medical male circumcision is performed in a medical and sterile setting by a trained professional (doctor or nurse) it is very safe. All Government clinic and hospitals and the organisations that work with them, for example CareWorks and CHAPS, are strictly monitored by USAID and CDC to ensure they provide the best medical male circumcision services possible. As long as you follow the wound care instructions, there is very little chance of any complications.
Can I Get Circumcised if I am HIV-positive?
HIV-positive Brothers who know their status are also welcome to come for circumcision. You may get medically circumcised depending on the results of a CD4 count test and the doctor’s recommendation. If you are not eligible for circumcision on the same day, a future appointment will be made when you can come to be circumcised.
It is very important that HIV-positive Brothers stick to abstaining from sex during the 6-week healing period because the open wound will expose your partner/s to HIV. Having sex or masturbating while the wound is still healing means risking an infection and/or damaging the wound, which means it will take even longer to heal.
If you test positive for HIV or have been living with HIV for some time, MMC can’t protect you or your partner from HIV but it still has many advantages:
- Reduces your risk of contracting sexually transmitted diseases or sexually
transmitted infections (STIs) such as herpes, syphilis, genital warts and
chancroid - Lowers the risk of penile cancer.
- Improves your hygiene because the head of the penis is easier to clean
- Reduces your partner’s risk of cervical cancer and STIs.
- Minimal downtime – You can go back to work on the day of your
circumcision or the next day. You will only need to take a few days off at
most. If you need to take time off the healthcare facility will provide you with
a medical certificate. - Having MMC done at a hygienic medical facility ensures that your
circumcision is done quickly, safely and to the highest standards.Healthcare workers can also help you through the healing process. - It can be performed free of charge at a health facility nearby
A BROTHER’S GUIDE TO GETTING CIRCUMCISED
Making an Appointment
To get safe, free and quick medical male circumcision SMS your full name to 30869 or call/send a free ‘please call me’ to 0606 3322 11.
What do I need to get circumcised?
You do not need anything to get circumcised. Just bring along your I.D if you are a South African.
If you are non-South African you are also welcome to come for medical male circumcision. Please bring some form of identification, such as a passport.
Before coming to the clinic make sure you have eaten well. You will not be circumcised if you arrive at the clinic under the influence of alcohol or drugs.
CIRCUMCISION CARE
It is very important that you do not have sex or masturbate for 6 weeks while the wound heals! If you do have sex or masturbate, you could get an infection, or you could cause damage to the wound, slowing healing and exposing yourself to HIV.
Talk to your partner before and after you have the circumcision to explain and discuss why you cannot have sex during the healing process. This will help both of you be more comfortable with abstaining from sex.
Keep the bandage on and dry for the first 2 days after your circumcision. On day 2 you should go back to the clinic or hospital so that a healthcare provider can remove the bandage and check the wound.
You must also go back to your clinic on Day 7 and at 6 Weeks after your circumcision.
If you experience excessive pain or bleeding before the time or have any concerns please contact your clinic/service provider as soon as possible.
Once you have gone to the clinic on Day 2 after your circumcision to have your bandage removed by the healthcare worker, it is recommended that you clean your wound twice a day immediately after showering or bathing to prevent infections.
To clean your wound:
- Clean a container by rinsing the container with boiling water every time
before cleaning your wound. This will help to prevent germs or bacteria that
may be in the container from infecting your wound. - Wash your hands before starting to clean your wound.
- Dissolve two teaspoons of salt into a cup of warm water (not hot or boiling).
- Take a clean face cloth and dip it into the cup with the salt solution and
gently wipe an area of the wound. Rinse the cloth in warm water before
wiping the next area. - Make sure that you wipe properly around stitches without pulling them in
order to prevent any infection or complications. This will prevent germs
being transferred from one area to another and will help to prevent
infections. - Once you have cleaned your wound wash out the container using soap and
hot water. Cover it with a plastic bag and put it in a place where it will not
get dust as this will help to prevent infections. When your wound has fully
healed clean the container with soap and hot water before throwing it away. - The wound should remain clean and dry every day.
You should clean your wound this way for two weeks, or until the wound is closed.
CIRCUMCISED VS UNCIRCUMCISED
If you were circumcised for religious or cultural reasons, your circumcision may only be a partial circumcision and not a full circumcision.
Circumcised – The entire foreskin is removed and the head of the penis is fully exposed
This kind of circumcision provides the full health benefits.
Partial circumcision – the foreskin covers some of the head of the penis – the head of the penis is partially exposed
This kind of circumcision has no health benefits.
Uncircumcised – The foreskin is totally intact – the head of the penis is totally covered by the foreskin
This kind of circumcision has no health benefits.
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