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BMC Public Health. 2012; 12: 67.
Published online Jan 22, 2012. doi:  10.1186/1471-2458-12-67
PMCID: PMC3298502
"Now we are in a different time; various bad diseases have come." understanding men's acceptability of male circumcision for HIV prevention in a moderate prevalence setting
Angela Kelly,1,2 Martha Kupul,1 Lisa Fitzgerald,3 Herick Aeno,1 James Neo,1 Richard Naketrumb,1 Peter Siba,1 John M Kaldor,4 and Andrew Vallelycorresponding author1,4, of the Male Circumcision Acceptability and Impact Study (MCAIS) team
1Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, PO Box 60, Goroka EHP 441, Papua New Guinea
2International HIV Research Group, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
3School of Population Health, University of Queensland, Brisbane, Australia
4Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research), University of New South Wales, Sydney, Australia
corresponding authorCorresponding author.
Angela Kelly: a.kelly/at/unsw.edu.au; Martha Kupul: martha.kupul/at/pngimr.org.pg; Lisa Fitzgerald: l.fitzgerald/at/sph.uq.edu.au; Herick Aeno: herick.aeno/at/pngimr.org.pg; James Neo: james.neo/at/pngimr.org.pg; Richard Naketrumb: richard.naketrumb/at/pngimr.org.pg; Peter Siba: peter.siba/at/pngimr.org.pg; John M Kaldor: jkaldor/at/kirby.unsw.edu.au; Andrew Vallely: avallely/at/kirby.unsw.edu.au
Received October 11, 2011; Accepted January 22, 2012.
Abstract
Background
Adult male surgical circumcision (MC) has been shown to reduce HIV acquisition in men and is recommended by the WHO for inclusion in comprehensive national HIV prevention programs in high prevalence settings. Only limited research to date has been conducted in countries experiencing moderate burden epidemics, where the acceptability, operational feasibility and potential epidemiological impact of MC remain unclear.
Methods
A multi-method qualitative research study was conducted at four sites in Papua New Guinea (PNG), with 24 focus group discussions and 65 in-depth interviews carried out among 276 men.
Results
The majority of men were in favour of MC being introduced for HIV prevention in PNG and considered improved genital hygiene, enhanced sexual pleasure and culturally appropriateness key factors in the acceptability of a future intervention. A minority of men were against the introduction of MC, primarily due to concerns regarding sexual risk compensation and that the intervention went against prevailing cultural and religious beliefs.
Conclusion
This is one of the first community-based MC acceptability studies conducted in a moderate prevalence setting outside of Africa. Research findings from this study suggest that a future MC program for HIV prevention would be widely accepted by men in PNG.
Keywords: Acceptability, Male circumcision, Papua New Guinea, HIV prevention
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