Understanding and addressing socio-cultural barriers to medical male circumcision in traditionally non-circumcising rural communities in sub-Saharan Africa

Gertrude Khumalo-Sakutukwa, Tim Lane, Heidi van-Rooyen, Alfred Chingono, Hilton Humphries, Andrew Timbe, Katherine Fritz, Admire Chirowodza, Stephen F. Morin

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Given recent clinical trials establishing the safety and efficacy of adult medical male circumcision (MMC) in Africa, attention has now shifted to barriers and facilitators to programmatic implementation in traditionally non-circumcising communities. In this study, we attempted to develop a fuller understanding of the role of cultural issues in the acceptance of adult circumcision. We conducted four focus-group discussions with 28 participants in Mutoko, Zimbabwe, and 33 participants in Vulindlela, KwaZulu-Natal, South Africa, as well as 19 key informant interviews in both settings. We found the concept of male circumcision to be an alien practice, particularly as expressed in the context of local languages. Cultural barriers included local concepts of ethnicity, social groups, masculinity and sexuality. On the other hand, we found that concerns about the impact of HIV on communities resulted in willingness to consider adult male circumcision as an option if it would result in lowering the local burden of the epidemic. Adult MMC-promotional messages that create a synergy between understandings of both traditional and medical circumcision will be more successful in these communities.

Original languageEnglish (US)
Pages (from-to)1085-1100
Number of pages16
JournalCulture, Health and Sexuality
Volume15
Issue number9
DOIs
StatePublished - Oct 2013
Externally publishedYes

Keywords

  • barriers
  • cultural identity
  • HIV
  • male circumcision
  • sexuality

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • General Medicine

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