Men's attitudes: A hindrance to the demand for voluntary medical male circumcision--a qualitative study in rural Mhondoro-Ngezi, Zimbabwe

Abstract

Male circumcision has witnessed a paradigm shift from being regarded as a religious and cultural practice to a global intervention strategy meant to curb transmission of HIV. This is particularly evident in sub-Saharan African countries where the HIV prevalence is greater than 15%. Zimbabwe adopted the voluntary medical male circumcision (VMMC) strategy in 2009; however, since then the uptake of the intervention has only 10% of the adult male population has reported having been circumcised. To better understand this limited uptake of VMMC, we conducted a qualitative study with uncircumcised men aged 15-79 years in Mhondoro-Ngezi, Zimbabwe. Through assessing men's attitudes towards VMMC in seven focus group discussions, conducted between July and August 2012, this article seeks to provide improved strategies for delivering this intervention in Zimbabwe. These data reveal that, in general, men have a negative attitude towards VMMC. Specific barriers to the uptake of VMMC included the perceived challenge to masculinity, post-circumcision stigma, lack of reliable and adequate information and perceptions about the appropriateness of VMMC. These results suggest that structural interventions aimed at reducing stigma related to circumcision, in addition to increased efforts to disseminate accurate information about VMMC, are required in order to dispel men's attitudes that hinder demand for VMMC.

Keywords: HIV prevention; attitudes; male circumcision.