A snip by any other name?

Imagine being born circumcised. Apparently, that is something of a common claim.

Dirk Taljaard, manager of the Bophelo Pele project - a male circumcision research centre at Orange Farm near Soweto - has heard this claim one too many times.

The length of the foreskin varies among men and does not always fully cover the head, leading to the perception among those with a naturally shorter foreskin that they have been naturally circumcised. “I’ve heard this many times, not once,” says Taljaard.

“Of course the foreskin varies between individuals and thus the size of the skin may vary, but circumcision is always the complete removal of the foreskin.” In a traditional circumcision, the foreskin in not always cut off entirely.

Orange Farm, an informal settlement, was the site of three major randomised tests which concluded that male circumcision is 60% effective against HIV. The other two sites were in Uganda and Kenya in 2007.

Taljaard worked on the Orange Farm trials and is still there, this time evaluating the uptake of the procedure within the community. About 120 men are coming for the procedure per day this winter – double the usual number of visitors. “There is still the belief that it’s better to do it in winter even though it doesn’t matter (when one does it),” says Taljaard.

Since 2008, the farm has offered circumcision to some 20 000 males, mainly from the area. The project has become something of a pilot scheme, providing valuable lessons ahead of the proposed mass roll out of medical male circumcision in South Africa.

Among other surprising revelations, Taljaard explained that during a recent study done at the farm about 42% of the men that claimed to be circumcised were in fact only partially circumcised – the result of an earlier traditional procedure.

“You have to show people a picture of what you mean otherwise, it’s just too much confusion,” Taljaard says.

Many men consider it socially desirable to be circumcised and hence are likely to be less than honest when asked if they have gone through it.