Male Circumcision within the context of HIV prevention in India: a qualitative study conducted among young men in Chandigarh, India

Abstract

Male circumcision has been advocated as an additional HIV prevention strategy but in India, it is not yet a part of the comprehensive HIV prevention package. In the Indian context male circumcision is strongly associated with specific religions and little is known about the socio-cultural and religious dimensions of this practice at the community level, the sensitivities attached to this practice, and its acceptance as a potential method of HIV infection prevention. The objectives of the study were to assess the level of knowledge and understanding of male circumcision among male youth of sexually active age group and to explore the practice of traditional male circumcision in a north Indian city. Data was collected by conducting 25 in-depth interviews, 5 key informant interviews and 2 focus group discussions. These interviews were tape recorded, transcribed, coded and analyzed using a qualitative software package. Results show that a majority of the respondents belonging to the non circumcising communities had limited understanding on male circumcision. Respondents from the circumcising community listed several benefits of doing male circumcision such as, better hygiene, prevention of infections, and enhancement of pleasure during sexual intercourse. The non circumcising community respondents considered male circumcision as a social stigma and carried the belief that approaching a traditional circumciser (nai or hajjam) to undergo circumcision will or may convert them to the religion of Islam. The acceptance of circumcision as a practice to improve health and prevent infections such as, HIV, looked seemingly negative among respondents from the non circumcising communities. Due to its strong association as an identifier of a particular religion, there are fears in adopting it and being discriminated or targeted as being a member of the minority community.