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Soka Uncobe

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[[Image:Soka Uncobe.PNG|right|thumb|Logo for the Soka Uncobe mass circumcision campaign.]]
"Soka Uncobe" is a phrase which means "circumcise and conquer" in siSwati,
<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=The plan is being launched as “Soka Uncobe” (“Circumcise and Conquer” in siSwati). | accessdate=2011-05-06
}}</ref> and it is a campaign to implement the "Accelerated Saturation Drive," which is the Swazi government's plan to circumcise 80% of the Swazi male population aged 18-49,
<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=The emphasis is on reaching 80 percent coverage with the Soka Uncobe campaign... | accessdate=2011-05-06}}</ref> with [[HIV ]] prevention as the pretext.
<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=But the biggest motivator for male circumcision services is the protection from HIV that circumcision affords. | accessdate=2011-05-06
}}</ref>
== Rationale ==
Swaziland is a country where the practice of having multiple concurrent sexual partners is prevalent,<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=In a country with the practice of having multiple concurrent sexual partners and the highest HIV prevalence in the world... | accessdate=2011-05-06}}</ref> and the country with the highest [[HIV ]] prevalence in the world. Swaziland has a very low prevalence of male circumcision,<ref>{{REFnews | last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=Since Swaziland is a very small country with a very high prevalence of HIV and a very low prevalence of MC, it provides a very good case study on the relationship between MC and HIV infections prevented. | accessdate=2011-05-06}}</ref> and this is has been indicated as one of the "driving factors" behind the high prevalence of [[HIV]],<ref>{{REFnews | last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=Various studies have identified main drivers of the epidemic: multiple concurrent sexual partners, low levels of male circumcision, inconsistent use of condoms and long periods of premarital sexual activity. | accessdate=2011-05-06}}</ref> although other studies have shown that [[HIV ]] transmission was more prevalent in the [[circumcised ]] population than it was in the [[intact ]] population.<ref>{{REFnews | last= | first= | coauthors= | url=http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf | title=Swaziland Demographic and Health Survey 2006-07 | date=2008 | publisher=Mbabane, Swaziland: Central Statistical Office and Macro International Inc. | quote=As Table 14.10 shows, the relationship between HIV prevalence and circumcision status is not in the expected direction. Circumcised men have a slightly higher HIV infection rate than men who are not circumcised (22 percent compared with 20 percent). | accessdate=2011-05-06
}}</ref>
== Purpose ==
The goal of Soka Uncobe is to "saturate the male population with circumcision."<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=This is different because it’s a population-level activity meant to saturate the male population. | accessdate=2011-05-06
}} </ref> The campaign seeks to make its people view male circumcision as one of several critical HIV prevention choices that men and their partners can make to live healthier lives and save their country.<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=...the goal... is to have people view male circumcision as one of several critical HIV prevention choices that men and their partners can make to live healthier lives and save their country. | accessdate=2011-05-06}}</ref> The Swaziland Soka Uncobe campaign focuses on encouraging women to encourage their partners to get [[circumcised]], and to support them through their 6-week abstinence period after the procedure.<ref>{{REFnews | last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=...women will play an active and important role in supporting their partners to get circumcised, especially in terms of observing the six-week abstinence period following the procedure. | accessdate=2011-05-06}}</ref> It also engages companies to encourage and support their male employees to get [[circumcised]].<ref>{{REFnews | last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=In late March, sugar cane companies will give their employees a few days of leave to get [[circumcised ]] and have some recovery time before beginning the annual harvest. | accessdate=2011-05-06
}}</ref>
== Aid from the United States ==
Soka Uncobe is acting under scientific models developed by the U.S. government, which predict that a scale up of [[circumcision ]] in Swaziland "will prevent approximately 45 percent of new infections between now and 2025." According to the models, By 2025, the number of new infections each year is projected to be "reduced by more than 80 percent compared with what would have happened had no intervention occurred.<ref>{{REFnews | last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=Scientific models developed by the U.S. government predict that this scale up in Swaziland will prevent approximately 45 percent of new infections between now and 2025. | accessdate=2011-05-06
}}</ref>
The plan to circumcise 80% of Swaziland's male population was approved in March or April of 2010 with the support of the US Government.<ref>{{REFnews
| last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=In March or April of 2010, the Swazi Cabinet approved the current plan, which the U.S. government agreed to support. | accessdate=2011-05-06}}</ref> Since then, U.S. government personnel have worked to align [[PEPFAR ]] resources in support of the national plan. The Government of Swaziland asked [[PEPFAR ]] to support the national [[Adolescent_and_adult_circumcision| male circumcision ]] plan as one of the "five pillars" of the Swaziland - — [[United States ]] [[PEPFAR ]] Partnership Framework on [[HIV]]/[[AIDS]].<ref>{{REFnews | last=Mazzotta | first=Meredith | coauthors= | url=http://sciencespeaksblog.org/2011/03/04/swaziland-embarks-on-ambitious-plan-to-circumcise-80-percent-of-men-18-to-49-this-year/ | title=Swaziland embarks on ambitious plan to circumcise 80 percent of men 18 to 49 this year | date=2011-03-04 | publisher=Science Speaks: HIV & TB News | quote=The Government of Swaziland asked [[PEPFAR ]] to support the national MC plan as one of the five ‘pillars’ of our “Swaziland – United States [[PEPFAR ]] Partnership Framework on [[HIV]]/[[AIDS]].” | accessdate=2011-05-06
}}</ref>
In March 22, 2011, the U.S. government officially handed over a wide range of materials in support of the USDF’s efforts to combat [[HIV]]/[[AIDS]], which included 7 prefabricated medical facilities supporting the Soka Uncobe male circumcision campaign. In all, the materials handed over at the ceremony and those that will be arriving in the future are valued at over E 12.5 million. Representing the [[United States ]] Government were Charge d’Affaires Craig Cloud, joined by Dr. Anne Thomas of the U.S. Department of the Defense, and in a speech given by Cloud, it was noted that "if the Soka Uncobe campaign is successful in circumcising 152,000 men during 2011, it could prevent 88,000 people from getting infected with [[HIV ]] and save the government and the people of Swaziland E 4.5 billion in medical treatment costs."<ref>{{REFnews | last=Press Release | first= | coauthors= | url=http://swaziland.usembassy.gov/pr32212.html | title=U.S. Government Hands Over E 12.5 Million in Materials and Equipment to USDF to Fight HIV/AIDS | date= | publisher=Embassy of the United States, Mbabane, Swaziland | quote=2011-03-22 | accessdate=2011-05-13
}}</ref>
== Mixed Message, Plan Backfiring ==
Soka Uncobe has already caused concern, as the message and imagery being used to promote it is sending the wrong message.<ref>{{REFnews
| last=Ndlangamandla | first=Nelsiwe | coauthors= | url=http://www.observer.org.sz/index.php?news=24311 | title='Soka uncobe' campaign questioned | date=2011-05-04 | publisher=The Swazi Observer | quote=THE public has received the Male Circumcision campaign "Soka Uncobe" with mixed feelings as some people have come out to say the message was not clear. | accessdate=2011-05-13}}</ref> Advertisements promoting the campaign display four women, sending confusing messages, one being that once one was [[circumcised]], they would be able to "conquer" more women. Regarding the logo and the slogan "Soka Uncobe" itself, some have gotten the message that “one has conquered” and would not get [[HIV ]] and [[AIDS]]. The greatest concern is that the message is promoting multiple concurrent partnerships.<ref>{{REFnews | last=Ndlangamandla | first=Nelsiwe | coauthors= | url=http://www.observer.org.sz/index.php?news=24311 | title='Soka uncobe' campaign questioned | date=2011-05-04 | publisher=The Swazi Observer | quote=»If it had been the picture of a family including the wife supporting her man, who goes to circumcise then that would be better, but in this case you see four beautiful women and it says they are going to support you, it is really confusing. Are they now promoting multiple partners?« said one of the people who raised a concern. | accessdate=2011-05-13
}}</ref>
Solomon Mndzebele, a caregiver under Red Cross, made a personal plea to the ministry Ministry of health Health to remove the advertizements advertisements because they were making making his job to promote condom use difficult.<ref>{{REFnews | last=Ndlangamandla | first=Nelsiwe | coauthors= | url=http://www.observer.org.sz/index.php?news=24311 | title='Soka uncobe' campaign questioned | date=2011-05-04 | publisher=The Swazi Observer | quote=Solomon Mndzebele, who is a caregiver under Red Cross, made a personal plea to the ministry of health to remove the message from the kombis stating that it was making his work difficult. | accessdate=2011-05-13}}</ref> According to Mndzebele, "When you tell people about condoms they would just tell you that they would circumcise and by then they would have conquered [[HIV ]] [[AIDS]]."
==Circumcision does not prevent HIV infection==
=== Population-based studies ===
{{Population-based studies}}
===Two African surveys===
The previously reported studies were from developed Western nations. Now we have information from Sub_Saharan Africa.
 
French scientist [[Michel Garenne]], Ph.D. has published two reports in 2022 comparing the incidence of HIV infection in [[circumcised]] and [[intact]] men.
 
In his first report, Garenne presented the findings from a study in Lesotho, the enclave in South Africa. He reported:
<blockquote>
In couple studies, the effect of circumcision and VMMC on HIV was not significant, with similar transmission from female to male and male to female. The study questions the amount of effort and money spent on VMMC in Lesotho.<ref name="garenne2022A">{{REFjournal
|last=Garenne
|first=Michel
|init=M
|author-link=Michel Garenne
|title=Changing relationships between HIV prevalence and circumcision in Lesotho
|url=https://pubmed.ncbi.nlm.nih.gov/35373731/
|date=2022-04-04
|journal=J Biosoc Sci
|volume=online ahead of print
|pages=1-16
|DOI=10.1017/S0021932022000153
|pubmedID=35373731
|accessdate=2022-11-07
}}</ref>
</blockquote>
 
In his second report, Garenne (2022) presented information from six Sub-Saharan African nations (Eswatini, Lesotho, Malawi, Namibia, Zambia, Zimbabwe). He reported:
<blockquote>
"Results matched earlier observations made in South Africa that [[circumcised]] and [[intact]] men had similar levels of HIV infection."<ref name="garenne2022B">{{REFjournal
|last=Garenne
|first=Michael
|init=M
|author-link=
|etal=no
|title=Age-incidence and prevalence of HIV among intact and circumcised men: an analysis of PHIA surveys in Southern Africa
|trans-title=
|language=
|journal=J Biosoc Sci
|location=
|date=2022-10-26
|season=
|volume=
|issue=
|article=
|page=
|pages=1-13
|url=https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/ageincidence-and-prevalence-of-hiv-among-intact-and-circumcised-men-an-analysis-of-phia-surveys-in-southern-africa/CAA7E7BD5A9844F41C6B7CC3573B9E50
|archived=
|quote=
|pubmedID=36286328
|pubmedCID=
|DOI=10.1017/S0021932022000414
|accessdate=2022-11-07
}}</ref></blockquote>
{{REF}}
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