Abstract

Introduction

There is compelling evidence that medical male circumcision partially reduces new HIV infections in men and consequently the scaling-up of male circumcision in several sub-Saharan African countries, including South Africa, has been recommended (WHO, 2007a, 2007b). In 2002, a national study in South Africa showed that 35% of men were circumcised, with ethnic variations (Connolly et al., 2008). Several studies have been conducted about the acceptability of introducing circumcision as an HIV prevention strategy, and generally the proportion of uncircumcised men who would consider circumcision was over 50% in African populations (Gasasira et al., 2012; Mavhu et al., 2011; Scott et al., 2005; Westercamp & Bailey, 2007). Factors identified with the acceptability of male circumcision include demographic, knowledge about benefits and social factors (Brito et al., 2009; Gasasira et al., 2012; Peltzer, & Mlambo, 2012; Westercamp et al., 2012; Yang et al., 2012).

Male circumcision-based HIV prevention programmes target young men, but little is known about the prevalence and acceptability of male circumcision in South Africa (Andersson & Cockcroft, 2012). Therefore, the objectives of the current study were to determine the rate and acceptability of male circumcision among South Africans.

Methods

Results

Discussion

In 2002 the Nelson Mandela/HSRC study showed that 35% of men in South Africa are circumcised (Connolly et al., 2008) while in the present 42.8% indicated that they had done so. This shows an increase in the prevalence of self-reported male circumcision. A similar increase (42%) was reported from the South African Second National HIV Communication Survey 2009 among men 16–55 years old (Johnson et al., 2010). Overall, African Blacks reported more circumcisions than other race groups. They undertook mostly traditional male circumcision especially in Limpopo and Eastern Cape provinces. Non-African Blacks (i.e., other race groups) used mostly medical circumcision. As regards the age at which most circumcisions were done, this was done mostly medically among Whites and Indians aged 0–1 years, traditionally among the Venda aged 2–11 years and Northern Sotho and Tsonga aged 12–7 years, and traditionally among the Xhosa and Ndebele aged 18years. These results replicate most of the findings reported by Connolly et al., (2008) from 2002.

The study found a high acceptability of male circumcision among the youth, as found in previous studies in sub-Saharan Africa (Gasasira et al., 2012; Mavhu et al., 2011; Westercamp & Bailey, 2007). In agreement with other studies (Brito et al., 2009; Mavhu et al., 2011; Westercamp et al., 2012), this study found that better knowledge about the benefits of male circumcision was positively associated with the acceptability of male circumcision. Given the above mentioned results this shows that the number of acceptability of male circumcision is in the increase and this would be a help in the process of promoting male circumcision as a partial protective measure towards HIV infection. South African is not an exception, where the youth accept male circumcision above the older generation. Similar results were found in countries like Malawi (Ngalande et al., 2006). Given the above results, there is an indication that both youth and adults females had a higher percentage of male circumcision acceptance as compared to their male counterpart.

The study limitations included the self-reporting of the male circumcision status. Because this survey was cross-sectional, no conclusions regarding causality can be drawn.

Conclusion

The study found high rates and high acceptability of male circumcision. Findings associated with the acceptability of male circumcision can be used to increase awareness of the benefits of male circumcision for HIV prevention. Adults and young men should continue to be the focus of programmes that aim to scale-up the demand for medical male circumcision services.

Acknowledgement

References