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

Abstract

Introduction Although traditional male circumcision (TMC) is still practiced in a number of countries, and its healing process may have a high risk of HIV and other STIs transmission, there have been no published systematic reviews on TMC, HIV risk, and impacts on circumcised men and their families. The aim of this study is to synthesise evidence of how TMC practices contribute to HIV transmission among males and the impacts of HIV on themselves and their families. Methods The systematic search started with an initial search following the PICO (Population, Intervention, Comparison and Outcomes) framework. A systematic review was conducted to find literature using databases including PubMed, CINHAL, SCOPUS, ProQuest, Cochrane, and Medline. The search was limited to the English language, and with no year limit in order to capture as many articles as possible about circumcision, traditional male circumcision, HIV, and impact on men and their families. Critical appraisal tools developed by the Joanna Briggs Institute (JBI) for study design were used to assess the methodological quality of included studies. Result A total of 18 studies were included: 11 were qualitative studies, 5 were quantitative studies, and 2 were mixed-method studies. All the studies included were conducted in areas where traditional male circumcision was performed (17 in Africa and 1 in Papua New Guinea). The findings of the review were categorized into themes namely TMC as a cultural practice, consequences of not being traditionally circumcised on men and their families, and TMC-related risk of HIV transmission. The review showed that TMC and HIV risk could bring significant and negative challenges for men and their families. Conclusion The findings indicated the need for targeted health intervention programs and efforts to address psychological and social challenges in communities practicing TMC. Prospero Number Registration: CRD42022357788.

The Impact on The Relocation of Ibu Kota Negara (IKN) Indonesia to The State of Sarawak

“…Sarawak and Indonesia have both participated in the field of medical tourism. Indonesians have been seeking medical treatment in neighbouring countries, such as Sarawak, for several reasons, including the presence of healthcare services, specialized medical expertise, patient-focused care, affordability, and religious and socio-cultural considerations (Asa et al, 2024). Sarawak has shown a strong interest in promoting medical tourism with Indonesia, acknowledging the potential for growth in healthcare services and tourism prospects (Dayak Daily, 2022).…”

“…Indonesian citizens have been travelling to Sarawak to receive medical care for a variety of reasons, such as the unavailability of specific therapies in their nation, the scarcity of medical specialists, and the absence of skilled doctors in remote areas of Indonesia (Asa et al, 2024). Indonesian patients constitute around 84% of all foreign patients in Sarawak, making them the majority of foreign patients in the region (Ormond & Sulianti, 2012).…”

Adolescent Experience in Performing Sifon Tradition (PostCircumcision Sex) in the Village of Fatumonas- Middle Amfoang, East Nusa Tenggara

“…Circumcision is also one of the most cost-effective and critical interventions to maintain progress towards the end of the HIV/AIDS epidemic [6] [7][8] [9]. Similarly, traditional circumcision can reduce the risk of HIV/AIDS infection in men [10]. HIV/AIDS prevention needs to achieve and maintain high circumcision coverage.…”

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

“…As a result, male circumcision is increasingly recommended as a strategy to reduce HIV transmission, particularly in areas with a high prevalence of HIV. [18][19][20][21][22][23][24][25][26][27] A WHO and the United Nations report has also highlighted a correlation between the lack of male circumcision and higher HIV rates, specifically in Eastern and Southern Africa. 28 Likewise, some meta-analyses showed that male circumcision protects significantly against HIV infection.…”

“…13 43 The possibility of acquiring HIV infection through TMC is also considered high due to sharing of a surgical knife or blade on multiple men. 23 27 44-46 TMC refers to the procedure of removing the foreskin of the penis in males in a non-clinical way by traditional circumcisers without formal medical training. 47 In addition to preparing newly circumcised males for the transition to manhood, TMC symbolises new initiates officially being accepted in the community with a new status of being a man and becoming a good model in family and society.…”