Abstract:
BACKGROUND: In recent randomized controlled trials, male circumcision has been
proven to complement the available biomedical interventions in decreasing HIV
transmission from infected women to uninfected men. Consequently, Tanzania is
striving to scale-up safe medical male circumcision to reduce HIV transmission.
However, there is a need to investigate the perceptions of male circumcision in
Tanzania using specific populations. The purpose of the present study was to
assess the perceptions of male circumcision in a cohort of police officers that
also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03)
trial in Dar es Salaam, Tanzania.
METHODS: In-depth interviews with 24 men and 10 women were conducted. Content
analysis informed by the socio-ecological model was used to analyze the data.
RESULTS: Informants perceived male circumcision as a health-promoting practice
that may prevent HIV transmission and other sexually transmitted infections. They
reported male circumcision promotes sexual pleasure, confidence and hygiene or
sexual cleanliness. They added that it is a religious ritual and a cultural
practice that enhances the recognition of manhood in the community. However,
informants were concerned about the cost involved in male circumcision and
cleanliness of instruments used in medical and traditional male circumcision.
They also expressed confusion about the shame of undergoing circumcision at an
advanced age and pain that could emanate after circumcision. The participants
advocated for health policies that promote medical male circumcision at
childhood, specifically along with the vaccination program.
CONCLUSIONS: The perceived benefit of male circumcision as a preventive strategy
to HIV and other sexually transmitted infections is important. However, there is
a need to ensure that male circumcision is conducted under hygienic conditions.
Integrating male circumcision service in the routine childhood vaccination
program may increase its coverage at early childhood. The findings from this
investigation provide contextual understanding that may assist in scaling-up male
circumcision in Tanzania.
