Introduction: Evidence from 3 randomized controlled trials in South Africa, Uganda and Kenya showing that male circumcision can reduce heterosexual transmission of HIV from infected females to their male sexual partners by up to 60% has led to a dramatic increase in the demand for circumcision in most African countries hard-hit by the HIV pandemic. Among communities where circumcision is not routinely practiced, this has created anxieties around possible deleterious effects of circumcision on erectile function. Most studies that have been conducted to explore the relationship between male circumcision and erectile function have yielded conflicting results (6-8, 14, 15). This study aimed to compare erectile function in circumcised and uncircumcised men in Lusaka, Zambia. Aim/objectives: To compare erectile function in circumcised and uncircumcised adult men aged 18 years and above in Lusaka, Zambia. Methods: Design: In this cross sectional survey, a total of 478 participants (242 circumcised and 236 uncircumcised) comprising patients, health workers and other men visiting the 4 study sites between 1/6/13 and 30/9/13 were handed the IIEF-5 questionnaire to complete. Information about participants’ age, relationship status, education level, smoking, alcohol use and medication use was also collected. The study included sexually active men older than 18 years living in Lusaka, Zambia. Males younger than 18 years, those lacking sexual experience and, those with serious mental and physical conditions were excluded from the study. Setting: Outpatient departments of 4 primary health care facilities in Lusaka, Zambia. Main Outcome Measure: Erectile function scores were calculated for the 2 groups. Normal erectile function was defined as an IIEF-5 score ≥22 (out of a possible maximum score of 25) points. Results: Circumcised men had higher average erectile function scores compared to their uncircumcised counterparts, U=23062.50, Z=3.64, p<0.001. The prevalence of ED was lower in circumcised men (56%) compared to that in uncircumcised ones (68%), 2 (N182) =7.52, df=1, p<0.05. Erectile function scores were similar in those circumcised in childhood compared to those circumcised in adulthood, 2 (N242) =0.29, df=1, p=0.59. The groups did not differ significantly in age, relationship status, smoking, alcohol use and medication use. However, a statistically significant difference was observed in education levels with the circumcision group showing higher levels, 2 (N478)=19.05, df=6, p<0.005. Conclusion: The higher erectile function scores in circumcised men observed in this study show that circumcision does not confer adverse effects on erectile function in men. Circumcision can thus be considered without concern about worsening erectile function. However, a prospective study in a similar cultural context is needed to confirm these findings.

NOTE FROM THE LIBRARY: PLEASE CONTACT THE AUTHOR AT indisunflower@yahoo.com OR CONSULT THE LIBRARY FOR THE FULL TEXT OF THIS THESIS.... This thesis investigates the trajectory traced from Sarah Baartman, a Khoisan woman exploited in Europe during the nineteenth century, to a contemporary writing workshop with circumcised, immigrant West African women in Harlem New York by way of a selection of African women's memoirs. The selected African women's texts used in this work create a new testimony of speech, fragmenting a historically dominant Euro-American gaze on African women's bodies. The excerpts form a discursive space for reclaiming self and as well as a defiant challenge to Western porno-erotic voyeurism. The central premise of this thesis is that while investigating Eurocentric (a)historical narratives of Baartman, one finds an implicitly racist and sexist development of European language employed not solely with Baartman, but contemporaneously upon the bodies of Black women of Africa and its Diaspora, focusing predominantly on the "anomaly of their hypersexual" genitals. This particular language applied to the bodies of Black women extends into the discourse of Western feminist movements against African female circumcision in the 21st century. Nawal el Saadawi, Egyptian writer and activist and Aman, a Somali exile, write autobiographical texts which implode a western "silent/uninformed circumcised African woman" stereotype. It is through their documented life stories that these African women claim their bodies and articulate nationalist and cultural solidarity. This work shows that Western perceptions of Female Circumcision and African women will be juxtaposed with African women's perceptions of themselves. Ultimately, with the Nitiandika Writers Workshop in Harlem New York, the politicized outcome of the women who not only write their memoirs but claim a vibrant sexual (not mutilated or deficient) identity in partnership with their husbands, ask why Westerners are more interested in their genitals than how they are able to provide food, shelter and education for the their families, as immigrants to New York. The works of Saadawi, Aman and the Nitandika writers disrupt and ultimately destroy this trajectory of dehumanization through a direct movement from an assumed silence (about their bodies, their circumcisions and their status as women in Africa) to a directed, historically and culturally grounded "alter" speech of celebration and liberation. / English Studies / D. Litt. et Phil.(English)

NOTE FROM THE LIBRARY: PLEASE CONTACT THE AUTHOR AT indisunflower@yahoo.com OR CONSULT THE LIBRARY FOR THE FULL TEXT OF THIS THESIS.... This thesis investigates the trajectory traced from Sarah Baartman, a Khoisan woman exploited in Europe during the nineteenth century, to a contemporary writing workshop with circumcised, immigrant West African women in Harlem New York by way of a selection of African women's memoirs. The selected African women's texts used in this work create a new testimony of speech, fragmenting a historically dominant Euro-American gaze on African women's bodies. The excerpts form a discursive space for reclaiming self and as well as a defiant challenge to Western porno-erotic voyeurism. The central premise of this thesis is that while investigating Eurocentric (a)historical narratives of Baartman, one finds an implicitly racist and sexist development of European language employed not solely with Baartman, but contemporaneously upon the bodies of Black women of Africa and its Diaspora, focusing predominantly on the "anomaly of their hypersexual" genitals. This particular language applied to the bodies of Black women extends into the discourse of Western feminist movements against African female circumcision in the 21st century. Nawal el Saadawi, Egyptian writer and activist and Aman, a Somali exile, write autobiographical texts which implode a western "silent/uninformed circumcised African woman" stereotype. It is through their documented life stories that these African women claim their bodies and articulate nationalist and cultural solidarity. This work shows that Western perceptions of Female Circumcision and African women will be juxtaposed with African women's perceptions of themselves. Ultimately, with the Nitiandika Writers Workshop in Harlem New York, the politicized outcome of the women who not only write their memoirs but claim a vibrant sexual (not mutilated or deficient) identity in partnership with their husbands, ask why Westerners are more interested in their genitals than how they are able to provide food, shelter and education for the their families, as immigrants to New York. The works of Saadawi, Aman and the Nitandika writers disrupt and ultimately destroy this trajectory of dehumanization through a direct movement from an assumed silence (about their bodies, their circumcisions and their status as women in Africa) to a directed, historically and culturally grounded "alter" speech of celebration and liberation. / English Studies / D. Litt. et Phil.(English)