ATTITUDES OF PREINITIATES TOWARDS TRADITIONAL MALE CIRCUMCISION IN THE CONTEXT OF HIV IN THE EASTERN CAPE, SOUTH AFRICA

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

OBJECTIVES

To synthesise evidence to determine whether, in contrast to medical male circumcision, traditional male circumcision (TMC) practices may contribute to HIV transmission and what the impacts of TMC are on the initiates, their families and societies.

DESIGN

Systematic review.

DATA SOURCE

PubMed, CINHAL, SCOPUS, ProQuest, Cochrane database and Medline were searched between 15 and 30 October 2022.

ELIGIBILITY CRITERIA

(1) Studies involving young men, young male adults, male adults and mixed male and female participants; (2) studies on TMC involving men living with HIV (married and non-married); (3) studies on TMC, HIV transmission and impact in low-income and middle-income countries; (4) qualitative, quantitative and mixed-method studies and (5) studies aimed at exploring TMC and how it contributes to HIV transmission and the impacts of HIV on circumcised men and their families.

DATA EXTRACTION

Data were extracted based on study details, study design, characteristics of participants and results.

RESULT

A total of 18 studies were included: 11 were qualitative studies, five were quantitative studies and two were mixed-method studies. All the studies included were conducted in areas where TMC was performed (17 in Africa and one in Papua New Guinea). The review's findings were categorised into themes: TMC as a cultural practice, consequences of not being traditionally circumcised on men and their families and TMC-related risk of HIV transmission.

CONCLUSION

This systematic review highlights that TMC practice and HIV risk could negatively impact men and their families. Existing evidence suggests that little attention has been paid to men and their families experiencing the impacts of TMC and HIV risk factors. The findings recommend the need for health intervention programmes such as safe circumcision and safe sexual behaviours following TMC and efforts to address psychological and social challenges in communities practising TMC.

PROSPERO REGISTRATION NUMBER

CRD42022357788.

Traditional male circumcision for reducing the risk of HIV infection: perspectives of young people in South Africa

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.