Traditional Male Circumcision Research Articles

Leveraging on indigenous knowledge systems for leadership development in young men: Discernable lessons from Ulwaluko amongst Xhosa speakers.

Ulwaluko or Traditional Male Circumcision is an old African practice that has survived years of criticism and attenuation of Western civilization through religion and education. With the growing Western influence on the continent, there is mounting questioning of the virtues of ulwaluko in some circles even amongst Africans themselves. Proponents of ulwaluko see the ritual as a potent tool for leadership development amongst young men. By adopting a qualitative research design, the authors collected data by interviewing young men who recently performed the ritual. Adopting a phenomenological approach helped the author understand the lived experiences of the target group. The researcher found that over time, there have been influences that sought to weaken and derail the intended objectives of ulwaluko. The researcher also found that leadership development has always been and continues to be integral to the ritual. The recommendations from the study are that the custodians of African cultural beliefs, customs, and values should reclaim their scope of influence and dominance on cultural practices. Greater awareness also needs to be created of the virtues of ulwaluko particularly amongst the younger generations. The author concludes that ulwaluko still plays a pivotal and prominent role in leadership development amongst young African males and that its benefits cannot be undermined.

Sexual Orientation Hiccups Surrounding Traditional Male Circumcision (Ulwaluko) in the South African Context: Implications for Social Work

Incontrovertibly, ulwaluko (traditional male circumcision) remains one of the essential rituals in developing an individual’s growth and construction of social identity, yet one of the ancient and patriarchal cultures. While some studies have been done on the experiences of homophobia by the LGBTQIA undergoing ulwaluko, there is a dearth of research on how social work professionals can intervene in curbing the homophobic and patriarchal undertones surrounding the traditions. Underpinned by Anti-Oppressive Practice as a theory, this paper argues that ulwaluko becomes problematic because it promotes heterosexualist practices which negate realities and experiences of self-identifying amaXhosa gay men. Through reviewing available literature, this paper argues that although human rights are universal, constructionists believe that social norms and values have an impact on how those rights are implemented, the paper further defined sexuality within the context of amaXhosa and also argues that social workers are not well trained with cultural competency.

Acceptability of Medical Male Circumcision as an HIV Prevention Intervention among Male Learners in a South African High School.

Circumcision is a long-standing and frequently performed surgical procedure which holds significant cultural significance among AmaXhosa people in South Africa. Due to cultural reasons in some parts of Africa, the integration of medical male circumcision with traditional manhood initiation rituals still lacks acceptance. This study examined the level of knowledge and acceptance of voluntary male medical circumcision (VMMC) among young males in a selected high school in the Nyandeni District of the Eastern Cape Province, South Africa. A descriptive, quantitative, cross-sectional study was conducted, and a self-administered questionnaire was used to obtain information on sociodemographic characteristics, knowledge of VMMC, perceptions of VMMC, and circumcision practices. One hundred participants were recruited from both grades 11 and 12, and 82% of the participants indicated that they had received information about VMMC. Most of the respondents (88%) preferred traditional male circumcision (TMC), and only 12% of respondents preferred VMMC. The participants displayed a good understanding of the distinction between VMMC and TMC. However, results from the study showed that most respondents exhibited low acceptability and knowledge towards VMMC. These findings highlight the need to develop evidence-based strategies to enhance learners' knowledge and acceptance of VMMC.

AN ECLECTIC STUDY ON STIGMA AND DISCRIMINATION SUBJECTED TO LGBTQIA INDIVIDUALS IN A SOUTH AFRICAN CONTEXT

Despite legal advancements and commitments made in South Africa, homophobia remains prevalent. In this article, various sources of literature – particularly journals – have been reviewed and it has been found that LGBTQIA individuals face significant violations of their rights. They also experience physical and mental health issues, are stigmatised and discriminated against, and are excluded from cultural practices such as traditional male circumcision. It has been established that social work can play a vital role in ensuring that LGBTQIA individuals have access to their rights, educating communities, and advocating for strict penalties against those who engage in homophobia.

A COMPARISON OF BEHAVIOUR AND MORALITY BETWEEN YESTERYEARS’ AND CONTEMPORARY INITIATES: THE CASE OF 2022 CALA AND MDANTSANE STUDY

This article compared the behaviour of yesteryear’s initiates and the contemporary ones in Cala and Mdantsane. This study aimed to explore the policy differences informing TMC in yesteryears and those in the contemporary epoch; to identify the similarities and differences between the behaviour of the two sets of initiates; and to establish the environmental factors motivating the behaviour of initiates. The exploratory and descriptive designs were used. One‑on‑one interviews with the guidance of an interview guide to facilitate interviews. The findings revealed that the yesteryears’ initiates behaved meticulously compared to those of contemporary epoch; embracement of chastity by the yesteryears’ initiates; contemporary initiates displayed wicked behaviours post initiation; the contemporary initiates’ behaviours influenced by illusionary interpretation of rights and tenets of development; Contemporary initiates entrenching culture of abusing substances. Government should ensure that traditional male circumcision achieves its objective. Training for traditional attendants; and hosting cultural events for cultural resuscitation.

Newspaper Coverage of Violence Related to Initiation and Traditional Male Circumcision in South Africa.

This study reports evidence of violence related to initiation and traditional male circumcision (ITMC) in South Africa. Our study conducted a search of the newspaper databases Newsbank and News24 from January 1, 2016, to August 31, 2023, and carried out a content analysis of newspaper articles that referenced violence in South African newspapers. Our initial search yielded 1796 articles; after screening for relevance and duplicates, 41 articles published in 16 South African newspapers and one online source were included in the analysis of the data. Most articles (41%) were published in 2016. Five major types of violence were identified at three unique stages of the ITMC process: (1) bullying; (2) mental and emotional abuse; (3) neglect; (4) physical violence; and (5) gender-based violence. At the pre-initiation stage, the articles reported that boys were forced, abducted, and trafficked into the initiation schools. While at the initiation schools, various forms of bullying, beating, fighting, slapping, assaulting, torturing, burning, neglecting, and physical, mental, and emotional abuse were reported. At the post-initiation stage, physical violence and mental abuse were reported. We noted that some articles reported violence prevention efforts during ITMC. Future research should examine readers' reception of newspaper information about violence associated with ITMC and their awareness of prevention measures. Our findings have implications for public health policy, including the Customary Initiation Act, which provides for the protection of life, the prevention of injuries, and the prevention of all forms of abuse that initiates may be subjected to as a result of initiation practices.

Black Women’s Perceptions Towards Infant and Child Male Circumcision

ObjectiveThe objective of this article was to analyse women’s perceptions of ICMC and to propose a framework for ICMC decision-making that can inform ICMC policies.MethodUsing qualitative interviews, this study investigated twenty-five Black women’s perceptions of ICMC decisionmaking in South Africa. Black women who had opted not to circumcise their sons, were selected through purposive and snowball sampling. Underpinned by the Social Norms Theory, their responses were analysed through in-depth interviews and a framework analysis. We conducted the study in the townships of Diepsloot and Diepkloof, Gauteng, South Africa.ResultsThree major themes emerged: medical mistrust, inaccurate knowledge leading to myths and misconceptions, and cultural practices related to traditional male circumcision. Building Black women’s trust in the public health system is important for ICMC decision-making.Conclusions for PracticePolicies should address misinformation through platforms that Black women share. There should be an acknowledgement of the role that cultural differences play in the decision-making process. This study developed an ICMC perception framework to inform policy.

Traditional male circumcision and the risk for HIV transmission among men: a systematic review

ObjectivesTo synthesise evidence to determine whether, in contrast to medical male circumcision, traditional male circumcision (TMC) practices may contribute to HIV transmission and what the impacts of TMC are on...

Early infant male circumcision: Potential for changing adverse gender norms associated with traditional male circumcision among circumcising communities in Kenya

Introduction: Traditional male circumcision (TMC) inculcates masculine-dominance norms in young men. Early infant male circumcision (EIMC) and medical male circumcision (MMC) can potentially minimise these adverse gender norms. We explored the perceptions about EIMC and MMC among communities practising TMC in Kenya. Method: We conducted focus group discussions with men and women and councils of elders, and key informant interviews with traditional circumcisers. Data were analysed using NVivo 10. Results: Most participants described MC as a rite of passage into adulthood, with the preferred age for MC to occur at 10 to 15 years old. Interestingly, awareness of the advantages of EIMC, especially among younger men and women, was high. Participants acknowledged that TMC reinforces hegemonic masculinity that undermines gender equality. Except among traditional circumcisers and some members of councils of elders, MMC and female providers were largely deemed acceptable. Conclusion: EIMC and MMC are slowly gaining acceptance, providing important tools to challenge adverse gender norms associated with TMC.

Exploring initiation schools' impact on HIV and AIDS management in the Vhembe district of South Africa: An ethnography.

This article presents the positive and negative impact traditional initiation schools have on the management of HIV and AIDS in the Vhembe district in South Africa. To explore the impact of initiation schools regarding the management of HIV and AIDS. This ethnographic study was conducted in rural villages in the Vhembe district. Nine purposively sampled key informants from the Vhavenda traditional healers and leaders participated in the study. Data were collected using semi-structured face-to-face interviews guided by an interview and observation guide. Data were analysed using ethnographic content analysis. The results indicated that the Vhavenda have different traditional initiation schools for boys and girls. For boys, there is Muḽa [traditional male circumcision], while Musevhetho [first stage of girls' traditional initiation before puberty], Vhusha [girls' second stage of traditional initiation] and Domba [final stage of girls' traditional initiation] are for girls. Some of the information provided perpetuates engagement in multiple concurrent relationships predisposing them to contract HIV. Boys are encouraged to be strong and to control women when it comes to sexual activities to suit their desire, whether the woman consented or not, while girls are taught to be submissive to their husbands which can fuel the spread of HIV. As the initiates are attentive to whatever is said during those initiation schools, there is an opportunity for using these initiation schools for proper prevention of HIV and instilling positive behaviours by using Leininger's cultural care modalities which focus on preservation of beneficial practices and repatterning of practices which fuel the spread of HIV. The study findings will aid in the review and update of the manuals and procedures for HIV and AIDS management.

Uptake of medical male circumcision with household-based testing, and the association of traditional male circumcision and HIV infection.

Voluntary medical male circumcision (VMMC) is an important component of combination HIV prevention. Inclusion of traditionally circumcised HIV negative men in VMMC uptake campaigns may be important if traditional male circumcision is less protective against HIV acquisition than VMMC. We used data from the HIV Prevention Trials Network (HPTN) 071 (PopART) study. This cluster-randomized trial assessed the impact of a combination prevention package on population-level HIV incidence in 21 study communities in Zambia and South Africa. We evaluated uptake of VMMC, using a two-stage analysis approach and used discrete-time survival analysis to evaluate the association between the types of male circumcision and HIV incidence. A total of 10 803 HIV-negative men with self-reported circumcision status were included in this study. At baseline, 56% reported being uncircumcised, 26% traditionally circumcised and 18% were medically circumcised. During the PopART intervention, 11% of uncircumcised men reported uptake of medical male circumcision. We found no significant difference in the uptake of VMMC in communities receiving the PopART intervention package and standard of care {adj. rate ratio=1·10 [95% confidence interval (CI) 0.82, 1.50, P = 0.48]}. The rate of HIV acquisition for medically circumcised men was 70% lower than for those who were uncircumcised adjusted hazard ratio (adjHR) = 0.30 (95% CI 0.16-0.55; P < 0.0001). There was no difference in rate of HIV acquisition for traditionally circumcised men compared to those uncircumcised adjHR = 0.84 (95% CI 0.54, 1.31; P = 0.45). Household-based delivery of HIV testing followed by referral for medical male circumcision did not result in substantial VMMC uptake. Traditional circumcision is not associated with lower risk of HIV acquisition.

The Construction of Manhood through the Performance of the Bukusu Circumcision Songs

Songs are part and parcel of the lives of many African communities as they carry values, norms, customs and aspirations of the communities. The Bukusu community, just like any other Kenyan community which adhere to the traditional customs has songs that are used in various rituals. Among the many rituals performed in Bukusu community is the traditional male circumcision, a rich theatre which is always accompanied by live tunes. The performance of these circumcision songs does not happen in a vacuum, it takes place within specified contexts which give rise to meaning. The Bukusu circumcision songs are socially significant as they have serious implications on the society’s beliefs. These songs are cultural symbols used to construct manhood in the sense that the newly initiates transits from childhood to adulthood. Once they go through this process, they are expected to be responsible adults who observe righteousness. This necessitates a concerted effort to unearth the construction of manhood through the performance of the Bukusu circumcision songs. The paper employed participant observation, oral interviews and open ended questionnaires in collecting songs. In sampling of the songs, the paper employed purposive sampling technique. This paper employed hermeneutics theory in examining how manhood is constructed through the performance of the Bukusu circumcision songs. The overall purpose of this paper is to contribute towards the understanding of how the Bukusu perceive and construct manhood through the performance of the Bukusu circumcision songs which will eventually contribute new knowledge to songs as a genre of oral literature.

STIGMA AND DISCRIMINATION SUBJECTED TO LGBTQIA INDIVIDUALS IN A SOUTH AFRICAN CONTEXT: A LITERATURE REVIEW

Ponte Academic JournalFeb 2023, Volume 79, Issue 2 STIGMA AND DISCRIMINATION SUBJECTED TO LGBTQIA INDIVIDUALS IN A SOUTH AFRICAN CONTEXT: A LITERATURE REVIEWAuthor(s): Kasa Luvo ,Simon Murote KangetheJ. Ponte - Feb 2023 - Volume 79 - Issue 2 doi: 10.21506/j.ponte.2023.2.4 Abstract:Despite the legal strides and commitment that have been made in South Africa, homophobia is still ripe. This article has reviewed numerous sources of literature, mainly from journals. It has been found that LGBTQIA suffers an immense violation of their rights; experience physical and mental health deficits; are subjected to stigma and discrimination, and suffer exclusion from cultural dispensation, especially in traditional male circumcision. It further established that social work has a huge role to play in ensuring that LGBTQIA individuals have access to all kinds of rights; spread education to communities, and advocate for severe penalties for perpetrators of homophobia. Download full text:Check if you have access through your login credentials or your institution Username Password

Behaviours of traditional male circumcision initiates of Cala and Mdantsane, South Africa

This article focuses on the exploration of behavioural deficits that are manifested by the traditional male circumcision (TMC) initiates of the contemporary epoch. A qualitative research approach amid an exploratory and descriptive design followed by interpretivism paradigm was applied. A purposive sampling technique of non-probability sampling method was used. The in-depth interviews and focus group discussions were used as data collection methods. Cala and Mdantsane were selected as research domains because of their involvement in the practice of TMC. Thematic analysis effected through coding was used to analyse data. The findings revealed that contemporary TMC initiates embrace negative teachings in the initiation school that fails to meet societal moral and ethical expectations, such as the preponderance of violence and abuse of alcohol. It also showed non-compliance to the moral code and cultural goalposts by the contemporary TMC initiates. Furthermore, this study recommends for policies to ensure that the rite achieves its sociocultural objective amid the training of traditional nurses and surgeons to astutely manage the rite.

IMPLEMENTATION OF THE TRADITIONAL MALE CIRCUMCISION POLICY IN SOUTH AFRICA

International, 40% of males stand initiated, customarily aimed at spiritual reasons. In popular several African communities, man removal of foreskin is conceded, obtainable intended for traditional purposes, mainly by way of a circumcision custom and a ceremony of path for male hood. The process here raised towards by way of modern man initiation stands regularly accomplished in a non-medical situation through an old-fashioned supplier with no official remedial profession. Once conceded out as a ritual of passageway into male hood, old-style man circumcision is largely accomplished on youngsters (Lowane, N.E., 2021). Traditional benefactors will remain to be a significant basis of initiation for several men in in our country, Research will be based on initiation, whether on medical male circumcision or tradition male circumcision (MMC or TMC), being elimination completely portion of the penis flesh on the penis. The aforementioned may also stand accomplished medically or surgically at hospitals or on circumcision places. Circumcision colleges execute this practice by way of an old-fashioned ceremony of passageway starting childhood to men then it mentioned towards by means of old-style man initiation (TMC). Circumcision exercise takes active even in nowadays has been accomplished only intended for customary or spiritual order, nevertheless the aforementioned cannot at all extended remain regarded lone by way of circumcision. The aforementioned should, instead, likewise remain understood by means of degree towards control the extent of the (HIV/AIDS) disaster. A sum of research lessons institute that initiated males consumed slighter probabilities of constricting AID contamination matched through uninitiated males. According to Palmer, E., Marais, L. and Engelbrecht, M., (2022). ritual circumcision in our country has no impact on social, politics and other sectors of government. This article will to contribute significantly to the implementation of the South African TMCA in the province of EC for study research on traditional male circumcision. Firstly, finding researched work on the issue of TMC is very difficult because there is so much secrecy about this traditional practice to an extent that information is mostly found in newspapers (Mellor, D., 2021). The research done by the World Health Organisation (WHO n.d) examined the practice of TMC in SouthAfrica, Eastern Cape. However, while pointing to some policy issues, it did not address the policy implementation in relation to the Traditional Male Circumcision Policy itself. The main focus of the study is to gain better understanding of the implementation of traditional circumcision policy, the government intervention on the practice and creating synergy between medical, traditional male circumcision and the law governing circumcision.

Epidemiology of Cancers in Zambia: A significant variation in Cancer incidence and prevalence across the nation.

Cancer is one of the leading causes of death worldwide. More than two-thirds of deaths due to cancers occur in low- and middle-income countries where Zambia belongs. This study, therefore, sought to assess the epidemiology of various types of cancers in Zambia. We conducted a retrospective observational study using the Zambia National Cancer Registry (ZNCR) population based data from 2007 to 2014. Zambia Central Statistics Office (CSO) demographic data were used to determine catchment area denominator used to calculate prevalence and incidence rates of cancers. Age-adjusted rates and case fatality rates were estimated using standard methods. We used a Poisson Approximation for calculating 95% confidence intervals (CI). The seven most cancer prevalent districts in Zambia were Luangwa, Kabwe, Lusaka, Monze, Mongu, Katete and Chipata. Cervical cancer, prostate cancer, breast cancer and Kaposi's sarcoma were the four most prevalent cancers as well as major causes of cancer related deaths in Zambia. Age adjusted rates and 95% CI for these cancers were: cervix uteri (186.3; CI = 181.77 - 190.83), prostate (60.03; CI = 57.03 - 63.03), breast (38.08; CI = 36.0 - 40.16) and Kaposi's sarcoma (26.18; CI = 25.14 - 27.22). CFR were: Leukaemia (38.1%); pancreatic cancer (36.3%); lung cancer (33.3%); and brain, nervous system (30.2%). The cancer population was associated with HIV with p-value of 0.000 and a Pearson correlation coefficient of 0.818. The widespread distribution of cancers with high prevalence observed in the southern zone may have been perpetrated by lifestyle and sexual culture (traditional male circumcision known to prevent STIs is practiced in the northern belt) as well as geography. Intensifying cancer screening and early detection countrywide as well as changing the lifestyle and sexual culture would greatly help in the reduction of cancer cases in Zambia.

Spatial distribution of traditional male circumcision and associated factors in Ethiopia; using multilevel generalized linear mixed effects model

BackgroundTraditional male circumcision (TMC) is primarily associated with a religious or cultural purpose and may lead to complications. To reduce risks of complication and long-term disabilities that may happen from circumcisions that are undertaken in non-clinical settings, information concerning TMC is very important. Therefore, this study is aimed at identifying spatial distribution of TMC and the factors associated with TMC in Ethiopia.MethodsA secondary data analysis was conducted among 11,209 circumcised males using data from 2016 Ethiopian Demographic and Health Survey (EDHS). Global Moran’s I statistic was observed to check whether there was a significant clustering of TMC. Primary and secondary clusters of TMC were identified by fitting Bernoulli model in Kulldorff’s SaTScan software. Multilevel Generalized Linear Mixed effects Model (GLMM) was fitted to identify factors associated with TMC.ResultThe spatial distribution of TMC was nonrandom across the country with Global Moran’s I = 0.27 (p-value < 0.0001). The primary clusters of TMC were identified in the southern part of Oromia and Tigray, northern part of SNNPR, Amhara, Gambella and Benishangul regions. Current age, age at circumcision, ethnicity, religion, place of residence, wealth index, media exposure, sex of household head and age of household head were factors associated with TMC in Ethiopia.ConclusionsThe spatial distribution of TMC was varied across the country. This variation might be due to the diversity of culture, ethnicity and religion across the regions. Thus, there is a need to rearrange the regulations on standards of TMC practice, conduct training to familiarize operation technique and general hygiene procedures, and launch cross-referral systems between traditional circumcisers and health workers. While undertaking these public health interventions, due attention should be given to the identified clusters and significant factors.

The Impact of Traditional Male Circumcision Challenges on Newly Initiated Men’s Advancement in Education: Implications for Human Rights and Social Work in South Africa

The Impact of Traditional Male Circumcision Challenges on Newly Initiated Men’s Advancement in Education: Implications for Human Rights and Social Work in South Africa

Concerns of Distressed Communities Towards Male Circumcision

ABSTRACT The relevance and sacredness of contemporary traditional male circumcision (TMC) as a rite has come under scrutiny in recent years by both stakeholders and the communities practising the rite. To examine the concerns of the distressed communities, the study adopted a qualitative approach complimented by exploratory, descriptive, and case study designs as its research design. A sample of three key informants, and purposively selected men and women from the Bisho community aged 30 years and over were utilised for the study. Participants shared an array of concerns and distresses associated with the rite, including 1) deterioration of the relevance of rite, 2) absence of family support systems, 4) portrayal of perfidious behaviour by initiation graduates, and 5) family and social responsibility proving to be a burden too heavy for initiation graduates. The study recommends the need for raising awareness on retrogressive aspects of TMC, the practical implementation of legislation by the government, and the strengthening of psycho-social support programmes for communities practising the rite.

Uptake and acceptability of medical male circumcision among young males in two culturally distinct settings in South Africa: A longitudinal, community-based study (the MACHO study).

Young South Africans experience high rates of HIV infection. While nationally scaled medical male circumcision (MMC) can help to curb HIV infection rates in countries such as South Africa (SA), MMC uptake has not been consistent or universal, suggesting variable acceptability among men. Both MMC and traditional male circumcision (TMC) are practised in SA. For male circumcision to be most effective for HIV prevention, it should be performed prior to sexual debut with complete removal of the foreskin. The MACHO (Male Adolescent Choices for HIV Prevention Options) study investigated uptake of and preference for MMC v. TMC in two culturally distinct settings in SA. This observational, longitudinal, cohort study investigated circumcision preferences and uptake in 100 males (aged 14 - 17years) and their legal guardians in Cape Town (Western Cape Province) and Soweto (Gauteng Province). Data were collected via surveys administered every 4 months over a 24-month period. A total of 100 uncircumcised adolescent boys (Cape Town n=50, Soweto n=50; mean (interquartile range) age 15 (14 - 16) years) and their guardians were enrolled. At baseline, 42 boys from Soweto (84%) and none from Cape Town expressed a preference for MMC over TMC. Sowetan participants were more likely to elect circumcision (MMC n=11 (22%), TMC n=1 (2%)) than those from Cape Town (TMC n=1 (2%), MMC n=0) over 13.6 months of follow-up (hazard ratio 18.9; 95% confidence interval 2.37 - 150.71; p=0.006). MMC was the preferred option for young men in Soweto compared with those in Cape Town, and this translated into practice. Despite knowledge of the benefits of early MMC, many participants delayed uptake, potentially reducing the MMC benefits before sexual debut. Programmes promoting circumcision should consider the influence of local practices. To realise full HIV prevention benefits, efforts should be made to ensure that circumcision is promoted, and that all circumcision is safe, performed prior to sexual debut, and contextually responsive.