Maibvise Charles, Mavundla Thandisizwe R
a University of Swaziland , Department of General Nursing , PO Box 369, Mbabane , Swaziland.
Afr J AIDS Res. 2014 Sep;13(3):281-9. doi: 10.2989/16085906.2014.952652.
Swaziland is currently experiencing the worst impact of HIV and AIDS of any country in the world. In an effort to curb further spread of the virus, the country adopted mass male circumcision (MC) as recommended by the World Health Organization in 2007. Despite intense campaigns to promote the procedure over the past three years, the uptake of circumcision remains very low for reasons that are not very clear. The purpose of this study was to explore the reasons for the low uptake of MC in Swaziland despite the massive national MC campaigns. A qualitative research design was used, in which all men who were targeted by the mass MC campaign were eligible. Participants were identified as they came for sexual and reproductive health services at the Family Life Association of Swaziland (FLAS) Clinic, Mbabane. In-depth, individual face-to-face unstructured interviews were conducted to elicit the reasons why men were not going for circumcision. A total of 17 men were interviewed. Results showed that these reasons include fear of the procedure and the possible outcome, perception of no significant benefit of the procedure, impatience about waiting for the procedure or the healing process, religious/cultural beliefs, and worries about the fate of the foreskin. These reasons were attributed to misconceptions and lack of accurate and specific information about some aspects of the circumcision strategy of HIV preventions. Physiological changes and economic activities associated with adulthood were also found to be hindrances to MC uptake. The study recommended that a comprehensive description of the procedure and more precise facts and scientific bases of the MC strategy be incorporated and emphasised in the MC campaigns. Involvement of religious leaders will also facilitate clarification of religious or cultural misunderstandings or misconceptions. A focus on neonatal MC would also help.
斯威士兰目前正经历着世界上任何国家中最严重的艾滋病毒和艾滋病影响。为努力遏制该病毒的进一步传播,该国于2007年按照世界卫生组织的建议采用了大规模男性包皮环切术(MC)。尽管在过去三年中开展了大力宣传该手术的活动,但包皮环切术的接受率仍然很低,原因尚不明晰。本研究的目的是探讨尽管开展了大规模全国性包皮环切术宣传活动,但斯威士兰包皮环切术接受率低的原因。采用了定性研究设计,所有大规模包皮环切术宣传活动的目标男性均符合条件。参与者是在姆巴巴内的斯威士兰家庭生活协会(FLAS)诊所前来寻求性健康和生殖健康服务时被确定的。进行了深入的、一对一的非结构化面对面访谈,以了解男性不接受包皮环切术的原因。共访谈了17名男性。结果显示,这些原因包括对手术及其可能结果的恐惧、认为该手术没有显著益处、对等待手术或愈合过程不耐烦、宗教/文化信仰以及对包皮命运的担忧。这些原因归因于对艾滋病毒预防包皮环切术策略某些方面的误解以及缺乏准确和具体的信息。与成年相关的生理变化和经济活动也被发现是接受包皮环切术的障碍。该研究建议,在包皮环切术宣传活动中纳入并强调对该手术的全面描述以及包皮环切术策略更精确的事实和科学依据。宗教领袖的参与也将有助于澄清宗教或文化方面的误解或错误观念。关注新生儿包皮环切术也会有所帮助。