Female Genital Mutilation and HIV/AIDS Risk

 

Female genital mutilation (FGM), is most prevalent in Africa(28 countries plus) and Central Asia, Europe Middle East etal and unfortunately statistics so far show more HIV/AIDS infected people in Africa than anywhere else in the world. Is there a link with the spread of HIV/AIDS.The practice has been linked to obstetrical and gynaecological problems in addition to mental and physical trauma that may result from the more severe forms of the procedure and is being widely condemned for both ethical and health reasons by the World Health Organization and other entities involved with Human Rights. The procedure is for some women a death sentence.  

Let’s face, what are the chances of survival in complications associated with FGM for a woman living in the back of a rural undeveloped African village? Those who think FGM should not end must think again. The horrors of FGM on a girl/ woman starts the day it’s done on her and carries on till death. It is after all women who go through child birth and all the other complications that can result in the death of either mother or child and in some cases both.

 

WHO has defined 4 types of circumcision:

I. Clitoridectomy

II. Excision (cutting of both the clitoris and part or all of the labia minora)

III. Infibulation (cutting of all external genitalia with stitching of the vaginal opening)

IV. Other less radical forms including pricking and piercing

It has been estimated that 80-85% of female circumcision is either type I or II.

From the definition it can be seen how horrific the practice is

K.E.Kun proposed 4 hypothetical mechanisms by which female circumcision could result in an

elevated risk of HIV infection(ref. K.E.Kun, 1997, Intl J Gynecology and Obstetrics)

In light of the alarming spread of HIV among females in a number of African countries where female circumcision continues to be practiced, there is no doubt that this could be linked.

Statistics has shown how much this is true as there are more women with HIV/ AIDS in Africa than anywhere else in the world. Does it mean they are more sexually active than their fellow women in the west? It is clear that there is a possibility that FGM plays a role. Traditional tools are used when performing the procedure and in most cases not sterilised. Because FGM raises the social status of the parents, the dowry demands can be high and therefore the young girls can be married off to older men who are already infected

Women who have had FGM done have a small opening, just large enough for the passage of urine and blood. Penetration or intercourse is difficult, often resulting in tissue damage, lesions, and postcoital bleeding. These tears would tend to make the squamous vaginal epithelium similar in permeability to the columnar mucosa of the rectum, thus facilitating the possible transmission of HIV.

Female circumcision and the risks

Infection/scarring

Partial/complete occlusion of the vagina

Greater risk of inflammation/bleeding during intercourse

Disruption of the genital epithelium/exposure to blood/penile abrasions which have been reported to enhance risk of HIV infection

Female circumcision

Higher incidence of obstructed labor and tearing

Haemorrhage

Higher risk of blood transfusion; blood supply may not be optimally screened for HIV.

 

Let’s call this practice what it actually is: the cultural creation of timid women!