Twitter’s monetization program rewards engagement. It’s not life changing amounts in the developed world. It is in much of Africa.

The map is fake. Please note the X community note on that post: "This map is the prevalence of male circumcision" from a 2024 study https://www.mdpi.com/2563-6499/5/3/36 (see figure 1)

The article is admittedly very difficult to follow, but that's not what it is saying.

That is something that it is quoting. Including a "community note" that it is a map of male circumcision from some academic paper.

The article is implying that the account that posted the map (which is "fake news" according to the community note in the screenshot) was revealed to be from some country other than the US.

Likely bots using VPNs.

it's not real you can safely ignore it

Imagine being paid in rubles to pretend you are from Ohio...