Key considerations in scaling up male circumcision in Tanzania: views of the urban residents in Tanzania

Abstract

Male circumcision (MC) reduces the risk of sexually transmitted infections (STI) including HIV. The WHO and UNAIDS recommend male circumcision as an additional intervention to prevent HIV infection. Tanzania is embarking on activities to scale up safe male circumcision for HIV prevention and other related health benefits. In line with this, it is crucial to assess views of the population using specific groups. This paper describes perceptions on male circumcision and strategies of enhancing uptake of male circumcision in urban Tanzania using members of the police force. This cross sectional survey was conducted among members of the police force in Dar es Salaam Tanzania from January 2010 to July 2010. The police officer serves as a source of the clinical trial participants in on-going phase I/II HIV vaccine trials. Three hundred and thirteen (313) police officers responded to a self-administered questionnaire that comprised of socio-demographic characteristics, reasons for not circumcising, perceptions regarding circumcision, methods of enhancing male circumcision, communication means and barriers to promote circumcision. This was followed by a physical examination to determine male circumcision status. The prevalence of circumcision was 96%. Most (69%) reported to have been circumcised in the hospital. The reported barriers to male circumcision among adults and children were: anticipation of pain, cost, fear to lose body parts, and lack of advice for adult's circumcision. Sensitization of parents who take children to the reproductive and child health services was recommended by most respondents as the appropriate strategy to promote male circumcision. The least recommended strategy was for the women to sensitize men. Use of radio programs and including male circumcision issues in school curricula as means of enhancing community sensitization regarding male circumcision were also highly recommended. Other recommendations include use of public media, seminars at work and issuance of circumcision regulations by health authorities. In conclusion, the present study reveals male circumcision was common in a selected urban population. There are various barriers and channels of communication regarding male circumcision. In view of scaling male circumcision in Tanzania, use of radio messages, inclusion of male circumcision in the school curricula and sensitization at the reproductive and child health clinics are likely to promote early medical male circumcision. __________________________________________________________________________________________

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

“…The hygiene aspect of medical circumcision appears to be a widespread perceived benefit of the procedure that has been observed in other settings in Africa (Tarimo et al, 2012). Similar findings have emerged in other African countries as well amongst rural and urban populations (Francis, et al, 2012). Older men also mentioned their desire to give their female partners sexual pleasure.…”

The perceptions on male circumcision as a preventive measure against HIV infection and considerations in scaling up of the services: a qualitative study among police officers in Dar es Salaam, Tanzania

“…In addition, the existing norm about male circumcision and the interaction of peers in this community may automatically convince men from the tribes that do not circumcise to perform circumcision. This may be reflected in the diversity of ethnic groups among informants in this study and in the results of a previous study from this population, which showed that 96% of the participants were circumcised [32]. In Ghana, the majority of boys are circumcised because of the desire to conform, which is an important motivation for performing circumcision among them [5].…”

“…The findings are drawn from a small number of participants and from a limited geographical area. Also, according to a previous study [ 32 ], male circumcision is a strong norm in this population, which might have influenced the stated perceptions. Therefore, the study informants may not represent the general population.…”

“…JF listened to the audio tapes and wrote a summary of the key findings. The generated summary was used to develop a questionnaire that quantified these qualitative findings [ 32 ]. At the same time, two assistants transcribed the audio-recorded material word for word.…”

The male circumcision: the oldest ancient procedure, its past, present and future roles.

“…This has lead to various stakeholders to recommend male circumcision as a complementary but not a substitute method in HIV prevention. The efforts to upscale male circumcision should be upheld countries where there is an ongoing campaign on male circumcision (Francis et al, 2012).…”