Page 120 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 2 of 6 Original Research

circumcised, 79.0% preferred VMMC and the students were endured from having unsafe sex and the benefits of VMMC.
willing to encourage others to opt for circumcision. This According to statistics, young people aged 15–24 account for
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prevalence in South Africa is because of massive scale-up of 39.0% of new HIV infections, which is a startling proportion.
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VMMC in different communities and mobilisation through A study conducted in Uganda among fishing communities
media platforms targeting young people. reported that there are several cultural beliefs about VMMC,
which include fear that foreskins are sold after removal, the
In December 2014, over 9 million VMMCs were performed in belief that a VMMC recipient’s first sexual partner after the
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all of the 14 priority countries in sub-Saharan Africa. In 2014, procedure should not be his spouse, and the belief that
only 3 million VMMCs were performed, which showed that vaginal fluids aid circumcision wound healing. On that
rapid VMMC scale-up has been implemented in most of sub- note, some researchers state that the primary motivations
Saharan Africa. According to UNAIDS targets, it is expected of VMMC are religious injunction, hygiene and protection
that by 2020, there should be an additional 27 million VMMCs against sexually transmitted infections (STIs) (not necessarily
done; these VMMC targets were based on the statistics HIV). 15,16 A study conducted in Kenya suggested that there
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obtained in 2014. There has been significant progress made is a need to dispel misconceptions about MC by involving
in scaling up VMMCs in 14 priority countries; during 2015 religious leaders and women’s groups, and making
Ethiopia and Kenya exceeded their 80.0% coverage of men circumcision relevant to men who are already practicing
performing VMMCs; Tanzania was on track to reach the an HIV preventative method. Another study conducted
expected target. Countries such as Lesotho, Malawi, Rwanda among university students in Zimbabwe revealed that only
and Zimbabwe were still lagging in 2015 with a low coverage a minority of them were willing to be circumcised; this
of 6.0% – 26.0%. There is also an urgent need to launch was mainly due to the negative attitude that students had
VMMC in Central African Republic and South Sudan. about VMMC. 4,17
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The Voluntary Medical Male Circumcision programme was A cross-sectional study was also conducted among adults in
launched in Kenya in 2008 following the WHO/UNAID rural Uganda, which revealed different negative perceptions
recommendation in 2007. Initially, Kenya aimed to circumcise about VMMC, especially in relation to its HIV protective
860 000 by 2013. The number of operations increased every measure. There is a concern about circumcision that is done
year from 8000 to 190 000 between 2008 and 2013. According after childhood. A study conducted among police officers in
to literature, 80.0% of the VMMCs in Kenya were conducted Dar es Salaam, Tanzania, raised concerns about circumcision
in the Nyanza province, where half of the uncircumcised conducted at older ages, as there is a view that pain can be
men live in Kenya. There is evidence of the overall success felt more and penile erection post circumcision can delay
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of the VMMC programme in Kenya, as most young people wound healing. 18,19 The integration of male circumcision into
begin their adolescent state to acknowledge this and ensure mother and child health services can motivate women to
they have done VMMC; the Kenyan government seeks to allow circumcision of their child at an early age, hence
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ensure that there is sustainability of the programme. alleviating many negative beliefs that the child can have as
According to the Centers for Disease Control and Prevention they grow older when they are not circumcised. Furthermore,
(CDC), the next step in Kenya is to accelerate VMMC among a group of researchers indicated that if more health education
males under the age of 15 and infants. By the end of 2014, in can be provided about different aspects of VMMC, some of
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Lesotho there were 85 000 men who had VMMC as part of the perceptions can be eliminated and corrected. Studies
HIV comprehensive prevention services; 56.0% of those men conducted in most African countries indicate that there is a
were tested for HIV; while in South Africa between 2012 and lack of knowledge and awareness about VMMC; while
2015 250 000 circumcisions were done. 7,12 another study that was conducted among university students
in Botswana revealed varied evidence that there is an increase
It is now well documented that a significant portion of South in the level of awareness of VMMC. 5,20 Similarly, a study
Africa’s indigenous population has been practicing the conducted among university students in Zimbabwe found
culture of male circumcision for centuries. For instance, male that the majority of students were aware about VMMC but
circumcision initiation schools in South Africa form part of failed to provide detailed information about the procedure.
the cultural practice. However, the integration of medical Despite people being educated through various media
male circumcision with traditional manhood initiation rituals platforms and promotion campaigns, literature has revealed
still seems to lack acceptability in these societies. Of note, that there is a knowledge gap about certain aspects of
about 70.0% of the men fear being stigmatised if they are VMMC. 3,18 A study conducted in Zimbabwe indicated that
circumcised medically in South Africa. As part of VMMC exposure to information on VMMC is important in order to
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promotion and awareness in South Africa, a number of increase the awareness. The most cited sources of information
organisations have been working closely with HEAIDS to were radio, television, newspaper and billboards. Another
assist with comprehensive HIV prevention services by study conducted among university students in Zimbabwe
motivating all male students to get circumcised. Within the showed that the majority of students were aware of VMMC
institutions of higher learning, such as colleges, there are but failed to provide detailed information about the
health promoters and VMMC mobilisers who continuously procedure; the only information they had was from public
interact with students about the implications that can be media. 3,17 There have been varied views by the general

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