Reducing the Spread of HIV through voluntary medical male circumcision: JSI’s experience in East Central Uganda
About eight years ago three randomized controlled studies showed done in Uganda, Kenya and South Africa showed that male circumcision for sexually active men provides up to 60% protection against HIV infection. Increasingly with support from PEPFAR, voluntary medical male circumcision (VMMC) is being added to other HIV prevention interventions in high HIV prevalence and low male circumcision prevalence areas, particularly in sub-Saharan Africa.
In late June, I was approached by an old friend, Dr. Paul Zeitz, Senior Vice-President of Policy for ACT V, to sign a statement calling for the U.S. government to develop a global AIDS strategy…A few weeks later, I and other signers received an invitation from Ambassador Goosby, U.S. Global AIDS Coordinator, to offer input for Secretary of State Hillary Clinton’s upcoming speech to the XIX International AIDS Conference.
I was born in the 80s, the same decade that the HIV epidemic began. Yet I was too young to remember the fear, the lives lost, the activism, and the scientific advances of the first decade of the epidemic. Fast forward to the 2000s where I found myself and my peers, as young people in the United States, unacquainted with the reality of HIV around us.
During my last semester of high school in 1983, I had an internship with a pathologist. For my final report, he suggested that I write about a new disease. It was an exciting idea because no one knew the cause of the disease and it was so different from anything seen until then. That was the first time I had done any work related to AIDS.
I got involved in the AIDS epidemic very inadvertently: A friend of mine who was working at Massachusetts Department of Public Health in the late eighties called and said they needed the expertise of those of us involved in developing community-based, long-term care services for elders.
In my medical residency program, we had a Family Practice Service where we would care for our own clinic patients and those of local family doctors. AIDS was new, virulent, implacable.
While growing up in Jos, Nigeria, one of my important mentors, Mary Beth Oyebade, started the Mashiah Foundation with her husband to support HIV+ women and widows. Their dedication to meeting the clear needs they saw showed me how relevant and important holistically addressing HIV/AIDS is in Nigeria. I just knew I was going to become a doctor.
“Timing is everything in life” is an adage with great meaning to me, largely because of the way my career in public health evolved, coincident with the onset of the HIV epidemic.
In 1988 I was living in NYC, doing my postgraduate courses as a Clinical Psychologist in Systemic Family Therapy. I was videotaping clinical sessions to help pay for my studies. I taped groups of psychologists discussing their cases. I was told that there were some cases of clients living with HIV and no one wanted to videotape those; I volunteered to do it, and that’s when I got trapped.
I can’t remember a time that HIV hasn’t been present in my life. As a closeted adolescent in the early 1980s, news of this mysterious illness killing homosexuals, Haitians, hemophiliacs and heroin users (the 4 Hs) spread at about the same time I began a process of accepting, becoming comfortable with and embracing this part of my identity.