Abstract
BackgroundBefore 19th century, in KwaZulu-Natal, South Africa, male circumcision was regarded as a right to passage to manhood; however, during the ruling of King Shaka Zulu, circumcision was abolished. It was only in 2010 that it was re-introduced, but this time in the form of medical male circumcision. The aim was to circumcise as many men as possible to avert new human immunodeficiency virus (HIV) infections, but few males utilise the circumcision services.AimThe aim of this study was to gain an understanding of the factors that hinder effective uptake of medical male circumcision.SettingThis study was conducted at Untunjambili area under iLembe district in KwaZulu-Natal province.MethodsThis qualitative, exploratory, descriptive and contextual study was conducted using in-depth unstructured face-to-face individual interviews at Untunjambili area under iLembe district in KwaZulu-Natal. A convenience sampling method was employed and participants aged between 18 and 49 years participated in the study.ResultsFactors that hinder effective uptake of medical male circumcision are organised into five categories: (1) fear (fear of pain, fear of death, fear of HIV test and fear of delayed wound healing, (2) personal factors (age at circumcision, lack of role models, procrastination and lack of volition, fertility and faithfulness), (3) knowledge deficit on circumcision, (4) influence of culture and (5) natural circumcision.ConclusionFactors that hinder effective uptake of medical male circumcision services are manifold. Cultivating a positive attitude towards medical male circumcision can promote uptake of circumcision services and a supportive social support system of men needs to be utilised to encourage men to be circumcised.
Highlights
Circumcision is the surgical removal of the foreskin from the penis and the practice is widely performed on boys and young men in Africa and other parts of the world (Mandova,Mutonhori & Mudzanire 2013). Morris et al (2016) explain that the estimated global prevalence of male circumcision is 38.7% and most of circumcised men are Jewish and Muslim
The World Health Organization (WHO) proposed a framework that seeks to contribute to the achievement of Millennium Development Goal (MDG) 6, which aimed at ensuring that the world has halted the spread of human immunodeficiency virus (HIV) by 2015 (WHO 2012)
The KwaZulu-Natal (KZN) province, where the study was conducted, once practised circumcision as a rite of passage before the times of King Shaka Zulu, this practice was disturbed in the Zulu tradition in the 19th century by King Shaka Zulu himself who believed it robbed him of many warriors at a time (Friedman, Rose & Titus 2011)
Summary
Circumcision is the surgical removal of the foreskin (prepuce) from the penis and the practice is widely performed on boys and young men in Africa and other parts of the world (Mandova,Mutonhori & Mudzanire 2013). Morris et al (2016) explain that the estimated global prevalence of male circumcision is 38.7% and most of circumcised men are Jewish and Muslim. The World Health Organization (WHO) proposed a framework that seeks to contribute to the achievement of Millennium Development Goal (MDG) 6, which aimed at ensuring that the world has halted the spread of human immunodeficiency virus (HIV) by 2015 (WHO 2012). This is in line with WHO and Joint United Nations Programme on HIV/AIDS (UNAIDS) recommendations that medical male circumcision (MMC) should be used as an additional important HIV prevention strategy for HIV prevention, in settings with high HIV prevalence and low levels of male circumcision (Kenya National AIDS and STI Control Programme 2011). The aim was to circumcise as many men as possible to avert new human immunodeficiency virus (HIV) infections, but few males utilise the circumcision services
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