Male circumcision as an HIV and AIDS prevention strategy: perspectives and experiences of students in university.

Abstract

HIV/AIDS is a critical public health issue in South Africa. Medical male circumcision has been acknowledged as one of the leading reduction strategies to combat HIV and other sexually transmitted infections. The aim of this study was to investigate the perspectives and experience of medical MC as an HIV prevention strategy amongst University of KwaZulu- Natal (Howard College) in Durban. The study employed a qualitative design using purposive and snowball sampling techniques and semi-structured interviews to recruit participants and record data from participants. Fifteen interviews were conducted, with both uncircumcised and circumcised men. The study found that male students generally acknowledge the role of MC in reducing HIV infection, additionally they can differentiate between medical male circumcision and traditional male circumcision. Moreover, the promoting factors for the uptake of MC were improved hygiene, the role of partners, reduced risk of contracting HIV and STIs, community support and improvement in male’s sexual performance and sexual experience. The key inhibiting factors that discouraged males from seeking circumcision include: fear of pain during and after the procedure, the role which is played by the staff in the clinics and hospitals, the six-week healing period before engaging in sexual activities, unwillingness to modify their body, partners and families’ negative influence in influencing circumcision and the usage of substances like alcohol and drugs. The recommendations in this study mainly focus on the need to increase the coverage of medical MC in Durban and to increase the uptake among males from ages 14-50 years. The recommendations include the need to evaluate the inhibiting factors which are barriers for males to undergo circumcision and promote the importance of enabling factors for males to undergo medical circumcision. Campaigns should focus on other promoting factors like hygiene, community involvements and improvement in sexual experience and sexual appearance, lastly the reduction of HIV and other sexually transmitted infections. When observing inhibiting factors, social mobilisation should focus on strategies to alleviate pain or fear of pain. The introduction of PrePex™ device would be a good method and subsequent expansion in the country. The different fears that males consider such as impact on sexual performance, discomfort and fear of embarrassment in the health care institutions would be allayed or alleviated. One of the most important factors is the need of health staff to be fully trained and clients should be fully assured that the entire circumcision process would be positive and easy.