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.

\ud 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. 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. 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. 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.\u

The Method of Hypno-circumcision in Klinik Khitan Plus Hypnosis in Pabuwaran Purwokerto Utara Subdistrict

This research explains the method of hypno-circumcision in the clinic. Generally, the service of circumcision still uses a conventional method and less of attention toward the psychological side. Whereas, this factor is very important on how affecting the patients view's toward circumcision. The main goal of this research is to know the implementation of hypnosis in medical field, especially circumcision process in Klinik Khitan Plus Hypnosis Pabuwaran.The method used in this research is descriptive-analysis. This method is used to provide an overview of the method of hypno-circumcision in Klinik Khitan Plus Hypnosis. This research found that method of hypno-circumcision in Klinik Khitan Plus Hypnosis is similar with hypnosis in general. The method of hypno-circumcision into four stages: preparation stage, induction stage, suggestion stage and termination stage. Preparation of hypno-circumcision in Klinik Khitan Plus Hypnosis begins from consultation to Ms. Novi as receptionist. Then, Induction is a main way to bring someone from conscious to subconscious mind. Giving suggestion is the core stage in the process of hypno-circumcision. Last stage is termination which defines as a gradual step to bring the subject to consciousness

Complications of circumcision in male neonates, infants and children: a systematic review.

BACKGROUND: Approximately one in three men are circumcised globally, but there are relatively few data on the safety of the procedure. The aim of this paper is to summarize the literature on frequency of adverse events following pediatric circumcision, with a focus on developing countries. METHODS: PubMed and other databasess were searched with keywords and MeSH terms including infant/newborn/pediatric/child, circumcision, complications and adverse events. Searches included all available years and were conducted on November 6th 2007 and updated on February 14th 2009. Additional searches of the Arabic literature included searches of relevant databases and University libraries for research theses on male circumcision.Studies were included if they contained data to estimate frequency of adverse events following neonatal, infant and child circumcision. There was no language restriction. A total of 1349 published papers were identified, of which 52 studies from 21 countries met the inclusion criteria. The Arabic literature searches identified 46 potentially relevant papers, of which six were included. RESULTS: Sixteen prospective studies evaluated complications following neonatal and infant circumcision. Most studies reported no severe adverse events (SAE), but two studies reported SAE frequency of 2%. The median frequency of any complication was 1.5% (range 0-16%). Child circumcision by medical providers tended to be associated with more complications (median frequency 6%; range 2-14%) than for neonates and infants. Traditional circumcision as a rite of passage is associated with substantially greater risks, more severe complications than medical circumcision or traditional circumcision among neonates. CONCLUSIONS: Studies report few severe complications following circumcision. However, mild or moderate complications are seen, especially when circumcision is undertaken at older ages, by inexperienced providers or in non-sterile conditions. Pediatric circumcision will continue to be practiced for cultural, medical and as a long-term HIV/STI prevention strategy. Risk-reduction strategies including improved training of providers, and provision of appropriate sterile equipment, are urgently needed

"After my husband's circumcision, I know that I am safe from diseases": Women's Attitudes and Risk Perceptions Towards Male Circumcision in Iringa, Tanzania.

While male circumcision reduces the risk of female-to-male HIV transmission and certain sexually transmitted infections (STIs), there is little evidence that circumcision provides women with direct protection against HIV. This study used qualitative methods to assess women's perceptions of male circumcision in Iringa, Tanzania. Women in this study had strong preferences for circumcised men because of the low risk perception of HIV with circumcised men, social norms favoring circumcised men, and perceived increased sexual desirability of circumcised men. The health benefits of male circumcision were generally overstated; many respondents falsely believed that women are also directly protected against HIV and that the risk of all STIs is greatly reduced or eliminated in circumcised men. Efforts to engage women about the risks and limitations of male circumcision, in addition to the benefits, should be expanded so that women can accurately assess their risk of HIV or STIs during sexual intercourse with circumcised men

Male Circumcision as an HIV Prevention Strategy in Sub-Saharan Africa: Socio-Legal Barriers

UNAIDS and WHO recommend safe, voluntary male circumcision as an additional, important strategy for the prevention of heterosexually-acquired HIV in men in areas with high HIV prevalence and low levels of male circumcision. Comprehensive male circumcision services should include HIV testing and counseling, partner reduction, and male and female condom use. Yet, male circumcision can have deep symbolic meaning that could pose barriers to implementation. In some parts of the world, it is a traditional practice with religious or cultural significance, in others it is a common hygiene intervention, and in yet others it is unfamiliar or foreign. Consequently, the proportion of men who are circumcised varies from \u3c5% to \u3e80%, with an estimated 30-40% of adult men circumcised worldwide. Confirming a number of observational studies, three randomized controlled trials in Africa have shown that circumcision reduces the likelihood of female-to-male HIV transmission by 50-60%, leading WHO/UNAIDS to conclude that the evidence is compelling . Male circumcision is a relatively simple, inexpensive one-time surgical procedure that is cost-effective, but raises a host of ethical, legal, and human rights challenges

Is Sex Like Driving? Risk Compensation Associated with Male Circumcision in Kisumu, Kenya

Mass adult male circumcision campaigns for HIV prevention are underway across much of Sub-Saharan Africa. However, concern remains about risk compensation associated with the reduction in the probability of HIV transmission per risky act. This paper examines the be- havioral response to male circumcision in Kisumu, Kenya. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision reduces fatalism about acquiring HIV/AIDS and increases the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient's belief about the reduction in the risk of acquiring HIV.HIV/AIDS, male circumcision, risk compensation, beliefs, Kenya

Christians’ Cut: Popular Religion and the Global Health Campaign for Medical Male Circumcision in Swaziland

Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom’s three ecumenical organisations, showing how a diverse group people singly glossed as ‘Christian’ in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision’s promotion and messaging as offensive and circumspect, and medical male circumcision as confounding gendered expectations and sexualised ideas of the body in Swazi Culture. Pentecostal-charismatic churches were seen as more likely to accept medical male circumcision, while traditionalist African Independent Churches rejected the operation. The procedure was widely understood to be a personal choice, in line with New Testament-inspired commitments to metaphorical circumcision as a way of receiving God’s grace

Men's perception regarding voluntary circumcision at a male clinic, Lesotho

Medical male circumcision prevalence in Lesotho remains at 23% even though efforts are made to encourage men to be circumcised. The purpose of this study was to explore and describe perceptions of men regarding male circumcision in a hospital in Morija, Lesotho and make recommendations on how to promote uptake of medical male circumcision. A descriptive, explorative and contextual qualitative design was used. In-depth, unstructured individual interviews were conducted on ten (10) uncircumcised men who were selected via purposive sampling. The findings revealed that men’s perceptions on circumcision can be classified under the following themes: perceived health beliefs of men about circumcision, perceived community-held beliefs about circumcision, men’s knowledge regarding circumcision, and perceived misconceptions about circumcision. It is recommended that knowledge on circumcision be reinforced and negative perceptions be corrected with the multi-sectoral approach to promote uptake of circumcision services.Health StudiesM.A. (Public health

THE IMPACT OF CIRCUMCISION TOWARDS WOMEN

Background: The controversy of female circumcision gives impact on banning agitation on female circumcision by International Women Amnesty towards Indonesian government. They consider that female circumcision aggrieved women. The problem of female circumcision is difficult to lose because it is related to culture and belief. Objective: Determining the effects of female circumcision. Methods: This study is a qualitative study with a phenomenological approach. Respondents consisted of 6 people: 4 people who are never circumcised, 1 person is a Paraji and 1 person is a Midwife. From those 4 respondents, 2 of them come are from Yogyakarta and the others are from Palembang . The sampling technique used purposely technique. The data were collected through in-depth interviews to the respondents. Research result: The research result shows 4 themes on female circumcision which includes perception towards female circumcision, time of implementation, factors which influence or encourage the implementation of female circumcision and the impact of female circumcision towards women. Circumcision technique is implemented by scratching a small part of clitoris using an equipment which has been boiled before or by symbolically cutting turmeric above the clitoris. Conclusion: Significant impact is absent in women who implement circumcision in Yogyakarta and Palembang

Circumcision debates in Sexology magazine (1934-1975)

This article explores articles about circumcision that appeared in Sexology: Sex Science Magazine, with particular attention to how the debates shifted and changed over a forty-year period. The articles on circumcision in Sexology begin in November 1934 and end in the May 1973 issue, with every decade of publication includes articles on circumcision, corresponding with growing debates about the medicalization of routine neonatal circumcision. The first article sought to understand “circumcision among savage peoples,” which was quickly followed by an article on “Circumcision among the Jews,” and then “Medical view of circumcision.” In its earliest issues, Sexology advanced arguments in favor of routine circumcision, but in its final article on the topic, Sexology asks, “what’s so good about circumcision?”Peer reviewedPublished. Article is open access and full text is available under a CC BY-NC 4.0 Creative Commons license in IRBU. Full text from the publisher is also available to BU community members via the DOI.Sexology magazinecircumcisionmedicalizatio