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Resistance to male circumcision campaigns in Southern Africa

Monday, 22 July, 2013

Male circumcision campaigns are failing to reach many men in Southern African countries despite compelling evidence that it can reduce the risk of HIV. Speakers at the 2nd International Conference for Social Sciences and Humanities in HIV argued the scarce attention to the social meanings of circumcision for many men has lead to the low coverage rates.

Three large-scale randomised control studies in South Africa, Kenya and Uganda showed male circumcision to reduce heterosexual HIV transmission by 60 percent. In 2007, UNAIDS and the World Health Organisation (WHO) consequently introduced recommendations for male circumcisions in countries of Southern and Eastern Africa, where HIV prevalence rates are high.

Following these recommendations, Swaziland, which has the highest HIV prevalence in the world, launched a government-led campaign aimed at circumcising 150,000 adult men in 2009. However, by 2011 only 12 percent of target males had been circumcised. Interviews with Swazi men found the perceived threat to masculinity to attribute to the procedure's unpopularity. The notion of reduced masculinity came from the belief circumcision would reduce sexual functionality that will in-turn jeopardise men's ability to have a family.

Similar to Swaziland, the circumcision campaign in Botswana fell well short of its mark, reaching only 40 percent of target men. Initially well received among communities where circumcision was already a cultural norm, it quickly became ill-favoured because of the way the campaign was carried out – “In 2011, everything turned around – the public campaigns had breached traditional privacy” commented Masego Thamuku, who conducted the research in Botswana. 

These findings highlight the need for further research into the cultural and social issues that effect men's decision to be circumcised, and for social aspects to be better integrated into policies on male circumcision as an HIV prevention tool.