The procedure, which takes about 30 minutes under local anaesthetic, involves the doctor snipping off the excess skin that covers the head of the penis (foreskin) and placing a few stitches that do not need to be removed. They fall out on their own once the wound is healed.
Before making the cut, Siyabonga says, he asked around. His uncle was one of the few men he knew who had had a medical circumcision and he told his nephew that it was a good idea to do the same.
“I was well again, back to my old self, without any problems”
“We had heard about how it protects against HIV and AIDS as in reducing against the chance of getting HIV/AIDS,” Siyabonga explains when asked why he decided to be circumcised.
He says more and more guys like him are hearing about this and taking it seriously, but that some are still surprised to learn of circumcision’s role in reducing the spread of the virus. His young brother, who is 16, was one of them, but now, Siyabonga says he is planning to be circumcised too.
In 2005, a landmark study conducted among a test group of South African men aged 18 to 24 showed that male circumcision reduced the transmission of HIV by almost 60 per cent. Two further studies in Uganda and Kenya found similar results.
Cutting off the foreskin removes the wet, warm and dark environment that can sustain viruses (like HIV and other sexually-transmitted infections, such as syphilis, herpes and cancroids). Circumcision exposes the skin at the head of the penis to open air where viruses die more quickly.
“More men are now coming, even if they don’t come with partners”
Siyabonga says he was counselled by clinic staff on the health benefits and that they also explained to him how to clean the area after his surgery. A patient should bathe the day after his circumcision and not allow the bandage to get wet. After two days he should remove the bandage and replace it with a new, clean bandage provided to him by the clinic.
Patients are encouraged to rest for a day or two after a circumcision, and are usually fully healed in four to six weeks.
This was a problem for David*, 28, an avid football player. To him the idea of a circumcision was a good one, but he had trouble finding the time. “I was so busy with soccer, honestly I did not make it a top priority,” he says.
To David, even a few days off from football could feel like an eternity but he says when he heard his local Marie Stopes South Africa clinic was offering circumcisions that would be of no charge to him, he knew to take advantage.
“My brother told me about it, he went, and so I went and the doctor told me more of the details, and I agreed that it was a good idea to be circumcised then,” David says.
Like Siyabonga, David says that the pain was less than he had expected. “It did last two weeks – the pain. But it was all gone in two weeks. After that I could get an erection, no problem,” he says.
Which for many guys considering a circumcision is a serious concern.
Siyabonga says that within three weeks, “I was well again, back to my old self, without any problems there.”
Both men report no changes in their sexual function, and David says he even hears that it has improved his chances with the ladies, “I heard from girls,” he pauses to chuckle, “they say the guy who’s circumcised is nice in bed.”
This is debatable. There are many theories about whether a circumcision increases a man’s sexual pleasure or performance, cleanliness and comfort. These all depend on the person and may not match everyone’s experience.
Whatever the other reasons for thinking about getting a circumcision there is one that is medically proven- to reduce the transmission of HIV and other STIs. Siyabonga and David both say that was the main reason for their circumcisions.
Siyabonga, who has been with his girlfriend for over a year, says “she likes it, she says its good. We still use condoms, and she takes the pills. So all the stuff about it being better- I don’t know if that’s true. You would have to ask her!” he explains laughing.
But for many, the idea of being circumcised is no laughing matter.
David said he heard a lot of myths from his peers, “I told some friends I was going and they said it was dangerous and that I could get sick and die from it. I explained no no. I told them what the doctor said to me, how it’s safe and medical in the clinic, no problems.”
His circumcision was over a month ago now and David says his friends are coming around. Some have even said they will consider going themselves. “I answer all their questions when they ask me about it,” he says.
The centre manager of the Marie Stopes South Africa clinic in Ulundi, Rufus Zulu reports that, “more men are now coming, even if they don’t come with partners, they are now coming to treat STIs and doing vasectomy. It’s no longer this thing of Marie Stopes being known as the abortion clinic or the women’s only clinic.”
Zulu says that “is the big change that is happening.”
South Africa’s medical circumcision campaign began in 2009 in KwaZulu-Natal and has been fully supported by Zulu King Goodwill Zwelithini. He called upon Zulu men to return to the ancient practice of male circumcision to promote HIV prevention and reduce the transmission of the virus.
Currently Marie Stopes South Africa offers circumcisions most KZN and Gauteng clinics.
Marie Stopes South Africa promotes medical male circumcision as one part of a comprehensive HIV prevention strategy along with the use of condoms and regular HIV testing (available for free to men and women at all 33 of our clinics in South Africa).
*Not his real name