Knowledge, attitudes and beliefs about male circumcision and HIV by traditional and medical providers of male circumcision and traditionally and medically circumcised men in Mpumalanga, South Africa

The aims of this study in Mpumalanga, South Africa, are to assess (1) the current behavioural risk reduction messages and HIV/AIDS education provided by medical and traditional providers of male circumcision to men undergoing medical and traditional circumcision and (2) the risk-related behavioural beliefs regarding circumcision, HIV/AIDS risks, condoms and gender attitudes among men who have undergone elective medical circumcision and men who have been circumcised in traditional initiation schools in the past 18 months. The sample included 13 male traditional providers and 13 male medical providers of male circumcision, and 15 traditionally and 15 medically recently circumcised men, all of an Ndebele cultural background. Qualitative analysis identified seven themes: (1) HIV/AIDS denial among men, (2) social influence of male circumcision including community norms and peer pressure, manhood initiation, perceived attitudes of women and traditional versus medical circumcision, (3) male circumcision is protective from HIV and sexually transmitted infections (STIs), (4) HIV and other risk from male (in particular traditional) circumcision, (5) male circumcision lowers sexual inhibition (abstinence, multiple partners, inconsistent condom use, increase in sexual desire and pleasure), (6) HIV/STI education and counselling and male circumcision, and (7) promotion of male circumcision. The implications of these findings for the development of effective male circumcision HIV/AIDS prevention programmes are discussed.