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Traditional Male Circumcision (TMC) as a feasible tool to increase HIV/AIDS response needs to be validated and advocated to especially its adherents who, from time immemorial, hold to the fact that its goal has been to achieve some socio-cultural goal posts and not HIV/AIDS response. The study investigated the perceptions of selected members of the Alice Town community and its environs on the role and position of traditional male circumcision becoming an HIV/AIDS prevention tool. The study adopted a qualitative paradigm and a case study design. With slightly differentiated interview guides, the researcher conducted seven in-depth interviews covering 8 participants and four focus group discussions involving 25 participants affiliated with Alice Hospice, Lavela Old Age Centre, and the University of Fort Hare. Findings established that TMC is grounded in achieving cultural goalposts, initiating a state of moral and ethical deficit, compromised HIV/AIDS prevention, clinical hazards heightened opportunities for HIV/AIDS infections, and commercialisation of male circumcision compromised HIV/AIDS prevention agenda. Recommendations made were that the government should ensure that cultural adherents understand the process of the biomedical process and its link with HIV/AIDS response. This study has emphasised the role of social workers in redressing the rights deficits experienced by the initiates and communities in general.

Objective: The 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. Method: Using 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. Results: Three 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 Practice: Policies 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. Significance: What is already known on this subject? Male circumcision decision-making is complex because multiple, interrelated factors influence it. Deciding about circumcising infants and children is a challenge that many parents face. What this study adds? This study found that social pressure from the social network, myths and misconceptions resulting from inaccurate knowledge, medical mistrust and traditional male circumcision practices influence the decisions of Black women not to circumcise their sons. The study proposes a perceptions framework to demonstrate consideration for Black women's voices in the male circumcision discourse. [ABSTRACT FROM AUTHOR]

This article compared the behaviour of yesteryears’ initiates and the contemporary ones in Cala and Mdantsane. This study explored 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 was adopted. The findings revealed that the yesteryears’ initiates behaved meticulously compared to those of the 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 entrenched culture of abusing substances. Ggovernment should ensure that traditional male circumcision achieves its objective. Training for traditional attendants; and hosting cultural events for cultural resuscitation. [ABSTRACT FROM AUTHOR]

Male circumcision is culturally motivated with a symbolic meaning of the rite-of-passage from boyhood to manhood in some African countries such as Uganda, particularly by the Bamasaaba local people from the Bugisu sub-region. This study aimed at investigating the local Bamasaaba people’s response to the implementation of the reformed health policies on male circumcision in the Bugisu sub-region in Uganda. The qualitative research approach adopted masculinity and Bourdieu’s theory of practice, presented through the lens of Habitus, which involved in-depth interviews with selected individuals and numerous Focus Group Discussion with the participants. Data analysis involved transcribing, interpretation, coding, categorising and generating the themes using the qualitative computer application known as Atlas. The results suggest that the Bamasaaba people have not accepted implementing the reformed health policies on male circumcision. However, these people are conditioned to rethink their traditional Imbalu (traditional male circumcision) practices due to the prevailing and persisting HIV/AIDS infections in their society.

Abstract Background Traditional 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. Methods A 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. Result The spatial distribution of TMC was nonrandom across the country with Global Moran’s I = 0.27 (p-value

Parental decision-making in infant and child male circumcision is influenced by complex, interrelated factors on many levels. Several studies have highlighted reasons for the acceptance and non-acceptance of child male circumcision. This study investigates the factors that influence parental decision-making in this matter and proposes a parental decision-making framework. The study was conducted in the townships of Diepsloot and Diepkloof in Gauteng, South Africa, using 48 in-depth interviews with parents, grandparents and uncles of the boys, as well as government officials and members of civil society as part of an explorative case study. Purposive and snowball sampling were used to select the participants. Thematic analysis was used to analyse the data by applying the conceptual framework of Bronfenbrenner's ecological systems theory. Three main themes emerged from the data: microsystem factors related to health and hygiene, the father's circumcision status, cultural expectations, pain, the child's autonomy and the extended family; mesosystem factors related to early childhood development centres; and exosystem factors related to circumcision policies and financial considerations. [ABSTRACT FROM AUTHOR]

Male circumcision is culturally motivated with a symbolic meaning of the rite-of-passage from boyhood to manhood in some African countries such as Uganda, particularly by the Bamasaaba local people from the Bugisu sub-region. This study aimed at investigating the local Bamasaaba people's response to the implementation of the reformed health policies on male circumcision in the Bugisu sub-region in Uganda. The qualitative research approach adopted masculinity and Bourdieu's theory of practice, presented through the lens of Habitus, which involved in-depth interviews with selected individuals and numerous Focus Group Discussion with the participants. Data analysis involved transcribing, interpretation, coding, categorising and generating the themes using the qualitative computer application known as Atlas. The results suggest that the Bamasaaba people have not accepted implementing the reformed health policies on male circumcision. However, these people are conditioned to rethink their traditional Imbalu (traditional male circumcision) practices due to the prevailing and persisting HIV/AIDS infections in their society. [ABSTRACT FROM AUTHOR]

Background: Traditional 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.Methods: A 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.Result: The 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.Conclusions: The 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. [ABSTRACT FROM AUTHOR]

The study took the form of a qualitative empirical case study in order to carry out a critical analysis of the shortcomings of existing policy pertaining to traditional male circumcision (TMC) in the Eastern Cape province of South Africa. Interview guides were developed to conduct in-depth interviews and focus group discussions with 28 participants. Among the principal conclusions from the findings were evidence of a lack of clarity on performing TMC operations, diverging perceptions of policy pertaining to TMC, unclear selection criteria for practitioners, and a lack of enforcement of policies which have been formulated. Recommendations are offered on the basis of the conclusions.

This article presents a case study of Simon, a 25-year old Black South African male. According to his Pedi customs, Simon underwent traditional male circumcision (TMC) as a 12-year-old adolescent. He tells of his fears relative to this experience and how, over time, he transitioned from a belief in TMC to a strong preference for medical male circumcision (MMC). Using a single-case study design, the aim of the research was to explore the value of the exercise of choice in TMC, which may influence cultural perceptions of gender and masculinity. The study unpacks the way in which the meaning and experience of TMC is shaped by the social and cultural contexts of South Africa. This qualitative exploration complements conventional medical accounts of circumcision, which are often focused on the medical procedure while ignoring cultural and social factors. Issues of gender, particularly the construction of hegemonic masculinity and how it positions men, women, and young boys in relation to each other and their communities, are discussed. Simon's case study provides new insights and perspectives on personally and culturally sensitive issues which are not easily accessed nor commonly understood. Data collected via in-depth interviews were transcribed and analyzed thematically. Analysis applied information from the literature and key concepts from the theoretical standpoint of social constructivism. Case study analysis allowed space for unexpected, emergent themes to arise from the data. Four main themes were identified, notably language, silence, patriarchy, and masculinity. [ABSTRACT FROM AUTHOR]

Aim: This article examined the health hazards associated with the contemporary traditional circumcision rite in Alice, Eastern Cape, South Africa. Methods: The study from which this article was extracted was explorative, descriptive, and employed a qualitative method. The study took use of one-on-one interviews, with the use of interview guide as an instrument to ease focus group discussions and interviews. Data were then analyzed thematically. Results: The findings brought the following factors; hospitalization of initiates; contraction of diseases; amputation of manhood organs; and maltreatment leading to health hazards. Conclusions: This article then recommended that, government, cultural custodians, and parents are requested to work hand in hand to curb all these health hazards associated with the contemporary rite. [ABSTRACT FROM AUTHOR]

Traditional male circumcision (TMC) is a cultural ritual that involves the removal of the penile foreskin of a male person undertaken as part of a rite of passage from childhood into adulthood. The aim of the study was to determine the notions of manhood in TMC by African adolescent boys in Ngove Village, Limpopo Province. This was a qualitative study that sampled a total of 20 adolescent boys through purposive sampling. Data were collected using semistructured interviews and analyzed through interpretive phenomenological analysis (IPA). Five main themes emerged from this study, namely: (a) TMC as a passage to manhood, (b) the role of TMC in role modeling, (C) fearlessness and aggressiveness as qualities of manhood in TMC, (d) TMC as indicating readiness for heterosexual relationships, and (e) the decline in the practice of TMC. The study concludes with discussion and recommendation of integration of both traditional male circumcision and medical male circumcision (MMC) with specific tactfulness and respect of the notion of manhood value embedment in the process to gain cooperation of the local community members affected. [ABSTRACT FROM AUTHOR]

The responsiveness to socioeconomic determinants is perceived as highly crucial in preventing the high mortality and morbidity rates of traditional male circumcision initiates in the Eastern Cape, a province in South Africa. The study sought to describe social determinants and explore economic determinants related to traditional circumcision of boys from 12 to 18 years of age in Libode rural communities in Eastern Cape Province. From the results of a descriptive cross-sectional survey (n = 1,036), 956 (92.2%) boys preferred traditional male circumcision because of associated social determinants which included the variables for the attainment of social manhood values and benefits; 403 (38.9%) wanted to attain community respect; 347 (33.5%) wanted the accepted traditional male circumcision for hygienic purposes. The findings from the exploratory focus group discussions were revolving around variables associated with poverty, unemployment, and illegal actions to gain money. The three negative economic determinants were yielded as themes: (a) commercialization and profitmaking, (b) poverty and unemployment, (c) taking health risk for cheaper practices, and the last theme was the (d) actions suggested to prevent the problem. The study concluded with discussion and recommendations based on a developed strategic circumcision health promotion program which is considerate of socioeconomic determinants. [ABSTRACT FROM AUTHOR]

Deaths of initiates occurring in the circumcision initiation schools are preventable. Current studies list dehydration as one of the underlying causes of deaths among traditional male circumcision initiates in the Eastern Cape, a province in South Africa, but ways to prevent dehydration in the initiation schools have not been adequately explored. The goals of this study were to (a) explore the underlying determinants of dehydration among initiates aged from 12 to 18 years in the traditional male circumcision initiation schools and (b) determine knowledge of participants on the actions to be taken to prevent dehydration. The study was conducted at Libode, a rural area falling under Nyandeni municipality. A simple random sampling was used to select three focus group discussions with 36 circumcised boys. A purposive sampling was used to select 10 key informants who were matured and experienced people with knowledge of traditional practices and responsible positions in the communities. The research findings indicate that the practice has been neglected to inexperienced, unskillful, and abusive traditional attendants. The overall themes collated included traditional reasons for water restriction, imbalanced food nutrients given to initiates, poor environmental conditions in the initiation hut, and actions that should be taken to prevent dehydration. This article concludes with discussion and recommendation of ways to prevent dehydration of initiates in the form of a comprehensive circumcision health promotion program. [ABSTRACT FROM AUTHOR]

The notion of manhood values is highly treasured and respected by various cultural groups practicing traditional male circumcision (TMC) in South Africa. This study was conducted at Libode, Eastern Cape, South Africa. The goals of this study were to (a) explore opinions and perceptions related to TMC among boys from 12 to 18 years of age, and (b) determine the actions to be taken to prevent high mortality and morbidity rates related to TMC. A simple random sampling was used to select three focus group discussions with 36 circumcised boys, and purposive sampling was used to select 10 key informants. The overarching themes collated included the following: (a) accepted age for circumcision, (b) causes attributed to deaths and complications, (c) TMC is preferred to medical male circumcision, and (d) acceptable community actions to prevent the problem. The study concludes with discussion and recommendation of a comprehensive health promotion program that is considerate of community opinions and perceptions in the prevention of deaths and complications affecting the circumcision initiates and at the same time respecting the culture. [ABSTRACT FROM AUTHOR]

Scientific evidence has shown that male circumcision reduces the risk of sexually related infections by providing men partial protection from contacting infections by at least sixty percent. This study describes the perceptions of youth on male circumcision as a sexual infections preventative strategy among the youths in Limpopo province. A qualitative ethnographic research was conducted. The research employed the use of face-to-face in-depth interviews in order to gather information from sixteen students from four tribal groups which were represented by four male students apiece. The sample was made up of participants from the following tribes: Venda, Tsonga, Pedi and Swati. Thematic content analysis was used to analyse data. The findings of the study showed that most traditionally circumcised men were not aware of the STIs protective effect of male circumcision, but rather most believed in the cultural and traditional effects of male circumcision in their communities. However, a few traditionally circumcised men had heard from different sources (media, peers, parents and health care providers) that male circumcision has a partial HIV protective effect. Research on male circumcision reveals that male circumcision reduces mens' risk of becoming infected through sex. However, few youths are aware of this prevention information. It has been noted that despite the dangers of traditional male circumcision, youth still prefer it. Hence, there is need for disseminating information and also finding ways of reducing risk associated with it. [ABSTRACT FROM AUTHOR]

This study explored the views of male community elders on traditional male circumcision at a clinic in the Limpopo Province. A qualitative research was conducted. The researchers used exploratory and descriptive design to guide the process of this study. Purposive sampling was followed and 18 male community elders between the ages of 40 to 75 years were interviewed. Semi-structured individual interviews were conducted and data were analysed using the Tesch's open-coding data analysis method. One theme with six subthemes emerged. The study found that traditional male circumcision had several unexpected and unsafe outcomes. It predisposes males to infections and bad environmental conditions. The period when the circumcision is performed could be viewed as a moral teaching session and the lessons learned could prepare boys for manhood. The study recommended that the National Department of Health should conduct workshops and training sessions for traditional circumcisers. This should include a focus on maintaining sterility during circumcision, in order to safeguard the initiates from becoming infected. [ABSTRACT FROM AUTHOR]

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Strong research evidence has shown that medical male circumcision significantly reduces heterosexual HIV acquisition among men. However, its effectiveness is enhanced by behavioural factors such as condom use. Currently, little is known of unprotected sex associated with male circumcision (MC) among alcohol-drinking tavern-going men, or whether engagement in unprotected sex may differ between men who have been traditionally circumcised and those who have been medically circumcised. The study sought to determine the relative importance of alcohol consumption and MC as correlates of unprotected sex and to compare the risk of engaging in unprotected sex between traditionally circumcised and medically circumcised tavern-going men from two rural villages in North-West province, South Africa. Data from 314 adult men (≥18 years) were analysed. The men were recruited from four bars/taverns using systematic sampling. They responded to questions regarding their demographic characteristics, alcohol consumption, circumcision status and method (where applicable), and engagement in unprotected sex. Descriptive analyses and bivariate and multivariate logistic regression analyses were conducted. Age, education, relationship status, alcohol consumption and traditional male circumcision (TMC) were independently and significantly associated with unprotected sex. Specifically, probable alcohol dependence and traditional circumcision were independent risk factors for engaging in unprotected sex among tavern-going men. Traditionally circumcised men had a higher risk of engaging in unprotected sex than medically circumcised men. Interventions aimed at reducing alcohol consumption, encouraging protective behaviour among men who have undergone TMC, and increasing condom use are needed in bar/tavern settings. HIV prevention education must be urgently incorporated into TMC programmes. [ABSTRACT FROM AUTHOR]

HIV voluntary counselling and testing (VCT) is a cornerstone of the national strategic plan for HIV/AIDS treatment, care and support in South Africa. However, research shows that the utilisation of VCT services is disappointingly low, particular among males. This article focuses on the factors associated with the intention to test for HIV-infection among recently initiated and traditionally circumcised men in the rural areas of Eastern Cape Province, South Africa. Individual face-to-face interviews were conducted among 1656 sexually active men. Logistic regression analyses were used to explore the association between intention to test for HIV and psychosocial factors. Overall, 35.1% of the participants reported ever having tested for HIV. Intention to test for HIV was positively associated with perceived probability of getting an STI, positive attitudes towards gender-based violence, received general teachings about being a responsible man and highest grade passed. These findings provide specific information that can be used in the development of a focused cultural sensitive STI/HIV prevention programme aimed to increase VCT uptake among sexually active young men, which can be integrated into initiation and health education practices. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that medical male circumcision is associated with a reduced risk of HIV infection for men in sub-Saharan Africa. The aim of this study was to understand the importance of male circumcision as a risk-reducing strategy by exploring perceptions of young men and women. The study draws on focus-group discussions conducted with both men and women in South Africa. The findings suggest that there is widespread support for traditional male circumcision. Traditional circumcision is viewed as a key part of the initiation process. However, a number of concerns were raised about the traditional initiation process, which may lead to risky sexual behaviours, including early sexual debut and multiple sexual partners. In addition, the risky sexual behaviour of men puts women at risk of HIV infection. [ABSTRACT FROM PUBLISHER]