Abstract
BackgroundThe World Health Organisation recommended the scale-up of voluntary medical male circumcision (VMMC) as an additional HIV prevention method in 2007 and several countries with high HIV prevalence rates including Zimbabwe have since adopted the procedure. Since then researchers have been preoccupied with establishing the level of knowledge and acceptability of circumcision in communities that did not traditionally circumcise. Despite evidence to suggest that knowledge and acceptability of voluntary medical male circumcision is high, there is also emerging evidence that suggest that uptake of circumcision among men has been below expectations. The purpose of this study was thus to investigate people’s representations of male circumcision that may influence its uptake.MethodsData for this study was collected through focus group discussions with men and women aged between 18 and 49 years. This age group was selected because they are still very sexually active and are within the target population of the upscale of voluntary medical male circumcision programme. Women were included in the study because they would be directly involved in a decision to have their son(s) get circumcised for HIV prevention. The study was carried out in Harare, Zimbabwe. Obtained qualitative data was analysed using thematic content analysis.ResultsResults suggest that circumcision is perceived as an alien culture or something for “younger” men or “boys” who are not yet married. The findings also suggest that there are beliefs that circumcision maybe associated with satanic rituals. The issue of condom use after circumcision was also discussed and it was found that some men do not see the need for using condoms after getting circumcised.ConclusionsThere is an urgent need for the development of communications that directly address the misconceptions about voluntary medical male circumcision. There is need for communication that encourages circumcised men to continue using condoms.
Highlights
The World Health Organisation recommended the scale-up of voluntary medical male circumcision (VMMC) as an additional HIV prevention method in 2007 and several countries with high HIV prevalence rates including Zimbabwe have since adopted the procedure
Zimbabwe adopted male circumcision for HIV prevention in 2009 as an additional HIV prevention strategy to augment HIV prevention programmes that were based on the ABC Model which advocates the promotion of abstinence, faithfulness, and the consistent and correct use of condoms
Studies on male circumcision have focused on the acceptability of male circumcision and the factors that may affect the favourable reception of this addition HIV prevention strategy with little attention being given to the meanings that people attach to circumcision
Summary
The World Health Organisation recommended the scale-up of voluntary medical male circumcision (VMMC) as an additional HIV prevention method in 2007 and several countries with high HIV prevalence rates including Zimbabwe have since adopted the procedure. The purpose of this study was to investigate people’s representations of male circumcision that may influence its uptake It is generally accepted in public health spheres that medical male circumcision is efficacious in the prevention of HIV infection. This follows evidence from randomised controlled trials in South Africa, Uganda and Kenya which showed that circumcision has a protective effect of up to 60 % on men [1,2,3]. These findings had a profound impact on the drive to scale up male circumcision for HIV prevention, and fuelled subsequent debates. Just like in the case of condoms, socially constructed meanings on voluntary medical male circumcision (VMMC) may provide a deeper understanding of the factors influencing VMMC uptake
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