“After my husband’s circumcision, I know that I am safe from diseases”: Women’s Attitudes and Risk Perceptions Towards Male Circumcision in Iringa, Tanzania

Layer, Erica H.; Beckham, S. Wilson; Mgeni, Lilian; Shembilu, Catherine; Momburi, Romani B.; Kennedy, Caitlin E.

doi:10.1371/journal.pone.0074391

Cited by 23 publications

(32 citation statements)

References 31 publications

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“…Some women also believed that circumcised men are slower than uncircumcised men to ejaculate, thus giving women greater sexual satisfaction. These results are consistent with findings from studies in Nyanza Province, Kenya, Tanzania and in Uganda where women were asked about their sexual satisfaction after their male partners were circumcised with 37% stating that they were more satisfied after their partner was circumcised versus 2% who were more satisfied when their partners were uncircumcised [34], [43]–[45]. While some women support MC based on their personal experience and beliefs, there may also be the potential for discrimination against uncircumcised men as circumcision programs scale up in sub-Saharan Africa.…”

Section: Discussionsupporting

confidence: 88%

Women's Beliefs about Male Circumcision, HIV Prevention, and Sexual Behaviors in Kisumu, Kenya

2014

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It is important to understand how women's sexual practices may be influenced by male circumcision (MC) as an HIV prevention effort. Women's beliefs about MC and sexual behaviour will likely influence the scale-up and uptake of medical MC. We conducted qualitative interviews with 30 sexually active women in Kisumu, Kenya. Women discussed MC related to perceived health benefits, condom use, sexual behaviour, knowledge of susceptibility to HIV and sexually transmitted infections (STIs), circumcision preference, and influence on circumcision uptake. Respondents had a good understanding of the partial protection of MC for acquisition of HIV for men. Women perceived circumcised men as cleaner, carrying fewer diseases, and taking more time to reach ejaculation. Male's circumcision status is a salient factor for women's sexual decision making, including partner choice, and condom use. It will be important that educational information affirms that MC provides only partial protection against female to male transmission of HIV and some STIs; that other HIV and STI prevention methods such as condoms need to be used in conjunction with MC; that MC does not preclude a man from having HIV; and that couples should develop plans for not having sex while the man is healing.

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Section: Discussionsupporting

confidence: 88%

Women's Beliefs about Male Circumcision, HIV Prevention, and Sexual Behaviors in Kisumu, Kenya

2014

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“…Such influence through beliefs about sexual performance has also been reported in many studies in WHO priority SMC countries [30, 28, 21, 36, 29, 37–39] and elsewhere [40]. Perception of partner preference for circumcised men has also been reported in other places [34, 24, 41, 26, 40, 42]. These widespread perceptions are also most likely influenced by the SMC social marketing campaigns.…”

Section: Discussionmentioning

confidence: 56%

Exploring drivers for safe male circumcision: Experiences with health education and understanding of partial HIV protection among newly circumcised men in Wakiso, Uganda

et al. 2017

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IntroductionAbout 2.5 million men have voluntarily been circumcised since Uganda started implementing the WHO recommendation to scale up safe male circumcision to reduce HIV transmission. This study sought to understand what influences men's circumcision decisions, their experiences with health education at health facilities and their knowledge of partial HIV risk reduction in Wakiso district.MethodsData were collected in May and June 2015 at five public health facilities in Wakiso District. Twenty-five in-depth interviews were held with adult safe male circumcision clients. Data were analysed using thematic network analysis.FindingsSafe male circumcision decisions were mainly influenced by sexual partners, a perceived need to reduce the risk of HIV/STIs, community pressure and other benefits like hygiene. Sexual partners directly requested men to circumcise or indirectly influenced them in varied ways. Health education at facilities mainly focused on the surgical procedure, circumcision benefits especially HIV risk reduction, wound care and time to resumption of sex, with less focus on post-circumcision sexual behaviour. Five men reported no health education. All men reported that circumcision only reduces and does not eliminate HIV risk, and could mention ways it protects, although some extended the benefit to direct protection for women and prevention of other STIs. Five men thought social marketing messages were ‘misleading’ and feared risk compensation within the community.ConclusionsParticipants reported positive community perception about safe male circumcision campaigns, influencing men to seek services and enabling female partners to impact this decision-making process. However, there seemed to be gaps in safe male circumcision health education, although all participants correctly understood that circumcision offers only partial protection from HIV. Standard health education procedures, if followed at health facilities offering safe male circumcision, would ensure all clients are well informed, especially about post-circumcision sexual behaviour that is key to prevention of risk compensation.

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“…In Kenya, as shown by a community-based survey, factors affecting opinion included a belief that circumcision was not part of the local culture, the perception of a long healing period following the procedure, the lack of a specific motivation to seek out services, and the general fear of pain associated with the circumcision procedure and healing process [23]. Finally, misinformation regarding the association of MC and HIV risk has been revealed in qualitative studies conducted in Tanzania [24] and South Africa [25]. …”

Section: Discussionmentioning

confidence: 99%

Women’s knowledge and perception of male circumcision before and after its roll-out in the South African township of Orange Farm from community-based cross-sectional surveys

et al. 2017

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The roll-out of medical male circumcision (MC) is progressing in Southern and Eastern Africa. Little is known about the effect of this roll-out on women. The objective of this study was to assess the knowledge and perceptions of women regarding MC in a setting before and after the roll-out. This study was conducted in the South African township of Orange Farm where MC prevalence among men increased from 17% to 53% in the period 2008–2010. Data from three community-based cross sectional surveys conducted in 2007, 2010 and 2012 among 1258, 1197 and 2583 adult women, respectively were studied. In 2012, among 2583 women, 73.7% reported a preference for circumcised partners, and 87.9% knew that circumcised men could become infected with HIV. A total of 95.8% preferred to have their male children circumcised. These three proportions increased significantly during the roll-out. In 2007, the corresponding values were 64.4%, 82.9% and 80.4%, respectively. Among 2581 women having had sexual intercourse with circumcised and uncircumcised men, a majority (55.8%, 1440/2581) agreed that it was easier for a circumcised man to use a condom, 20.5% (530/2581) disagreed; and 23.07 (611/2581) did not know. However, some women incorrectly stated that they were fully (32/2579; 1.2%; 95%CI: 0.9% to 1.7%) or partially (233/2579; 9.0%; 95%CI: 8.0% to 10.2%) protected when having unprotected sex with a circumcised HIV-positive partner. This study shows that the favorable perception of women and relatively correct knowledge regarding VMMC had increased during the roll-out of VMMC. When possible, women should participate in the promotion of VMMC although further effort should be made to improve their knowledge.

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“After my husband’s circumcision, I know that I am safe from diseases”: Women’s Attitudes and Risk Perceptions Towards Male Circumcision in Iringa, Tanzania

Cited by 23 publications

References 31 publications

Women's Beliefs about Male Circumcision, HIV Prevention, and Sexual Behaviors in Kisumu, Kenya

Women's Beliefs about Male Circumcision, HIV Prevention, and Sexual Behaviors in Kisumu, Kenya

Exploring drivers for safe male circumcision: Experiences with health education and understanding of partial HIV protection among newly circumcised men in Wakiso, Uganda

Women’s knowledge and perception of male circumcision before and after its roll-out in the South African township of Orange Farm from community-based cross-sectional surveys

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