Low acceptability of medical male circumcision as an HIV/AIDS prevention intervention within a South African community that practises traditional circumcision.

نویسندگان

  • Daniella Mark
  • Keren Middelkoop
  • Samantha Black
  • Surita Roux
  • Llewellyn Fleurs
  • Robin Wood
  • Linda-Gail Bekker
چکیده

BACKGROUND Traditional circumcision is practised among some indigenous tribes in South Africa (SA) such as the Xhosa. Recent experimental evidence has demonstrated the benefits of male circumcision for the prevention of HIV infection in heterosexual men. The acceptability of circumcision as a biomedical intervention mirroring an ingrained cultural practice, as well as the age and extent of the procedure, are poorly understood. METHODS Men aged 15 - 42 years were recruited in a peri-urban settlement near Cape Town. Participants completed an interviewer-administered questionnaire assessing self-reported circumcision status, context and reasons for previous or planned circumcision, and willingness to undergo medical circumcision for themselves or their sons. Results were confirmed by clinical examination. The most recent HIV test result was compared with circumcision status. RESULTS Of the 199 men enrolled, 148 (74%) reported being traditionally circumcised; of the 51 not circumcised, 50 were planning the traditional procedure. Among men self-reporting circumcision, 40 (27%) had some or all of the foreskin remaining. The median age at traditional circumcision was 21 years (interquartile range 19 - 22 years). While knowledge of the preventive benefit of circumcision was reported by 128 men (66%), most were unwilling to undergo medical circumcision or allow their sons to do so, because of religion/culture, notions of manhood, and social disapproval. CONCLUSION Almost all men in this study had undergone or were planning to undergo traditional circumcision and were largely opposed to the medically performed procedure. In the majority, traditional circumcision had occurred after the mean age of sexual debut and almost a quarter were found to have only partial foreskin removal. To ensure optimal HIV prevention benefits, strategies to facilitate complete foreskin removal prior to sexual debut within traditional circumcision practices require further attention.

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منابع مشابه

Prevalence and acceptability of male circumcision in South Africa.

BACKGROUND The objectives of the current national study were to determine the rates of self-reported circumcision among South African men and, more importantly, evaluate the acceptability of male circumcision in South Africa by uncircumcised adult men and all adult women. MATERIALS AND METHODS The study based on a population-based survey included a nationally representative subgroup of 6654 m...

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The acceptability of male circumcision as an HIV intervention among a rural Zulu population, Kwazulu-Natal, South Africa.

Epidemiological and biological studies provide compelling evidence for the protective effect of male circumcision against the acquisition of HIV. Three randomized controlled trials are currently underway to assess the impact of male circumcision as an HIV intervention in traditionally non-circumcising areas with high levels of heterosexually-transmitted infection. This study explores the accept...

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The medical proof doesn't get much better than VMMC.

March 2012, Vol. 102, No. 3 SAMJ 1. Ncayiyana DJ. The illusive promise of circumcision to prevent female-to-male HIV infection – not the way for South Africa. S Afr Med J 2011;101:775-777. 2. Auvert B, Taljaard D, Rech D, et al. Effect of the Orange Farm (South Africa) male circumcision rollout (ANRS-12126) on the spread of HIV. 6th IAS Conference on HIV Pathogenesis, Treatment, and Prevention....

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Male circumcision and its relationship to HIV infection in South Africa: results of a national survey in 2002.

OBJECTIVE To investigate the nature of male circumcision and its relationship to HIV infection. METHODS Analysis of a sub-sample of 3 025 men aged 15 years and older who participated in the first national population-based survey on HIV/AIDS in 2002. Chi-square tests and Wilcoxon rank sum tests were used to identify factors associated with circumcision and HIV status, followed by a logistic re...

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عنوان ژورنال:
  • South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

دوره 102 6  شماره 

صفحات  -

تاریخ انتشار 2012