Abstract
Local beliefs and practices about voluntary medical male circumcision (VMMC) may influence uptake and effectiveness. Data were gathered through interviews with 40 people from four ethnically mixed fishing communities in Uganda. Some men believed that wound healing could be promoted by contact with vaginal fluids while sex with non-regular partners could chase away spirits – practices which encouraged unsafe sexual practices. Information given by providers stressed that VMMC did not afford complete protection from sexually-transmitted infections, however, a number of male community members held the view that they were fully protected once circumcised. Both men and women said that VMMC was good not just for HIV prevention but also as a way of maintaining hygiene among the men. The implementation of VMMC in high-HIV prevalence settings needs to take account of local beliefs about circumcision, working with local religious/social group leaders, women and peers in the roll-out of the intervention.
Highlights
Three randomised controlled clinical trials (RCTs) conducted in Africa between 2002 and 2006 found that medical male circumcision significantly reduced female-to-male transmission of HIV by about 60% (Auvert et al, 2005; Bailey et al, 2007; Gray et al, 2007; Wamai, Morris, Bailey, Klausner, & Boedicker, 2015)
The aim of this paper is to examine the influence that different understandings and beliefs about male circumcision may have on voluntary medical male circumcision (VMMC) in fishing communities on the shores of Lake Victoria, Uganda, an ethnically mixed setting with high HIV prevalence
The dominant group of people living in the four villages were from the Baganda ethnic group from central Uganda, a traditionally non-circumcising people
Summary
Three randomised controlled clinical trials (RCTs) conducted in Africa between 2002 and 2006 found that medical male circumcision significantly reduced female-to-male transmission of HIV by about 60% (Auvert et al, 2005; Bailey et al, 2007; Gray et al, 2007; Wamai, Morris, Bailey, Klausner, & Boedicker, 2015). Following recommendations by the World Health Organisation and other international bodies, national programmes for voluntary medical male circumcision (VMMC) are underway in several sub-Saharan African countries with high HIV prevalence and low prevalence of male circumcision, as part of HIV combination prevention packages. An estimated nine million VMMCs have been undertaken since 2007 in eastern and southern Africa (The AIDS Vaccine Advocacy Coalition (AVAC) & Family Health International (FHI), 2010; WHO/UNAIDS, 2007).
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