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BMC Public Health. 2012; 12: 529.
Published online Jul 19, 2012. doi:  10.1186/1471-2458-12-529
PMCID: PMC3416658
The perceptions on male circumcision as a preventive measure against HIV infection and considerations in scaling up of the services: a qualitative study among police officers in Dar es Salaam, Tanzania
Edith AM Tarimo,corresponding author1 Joel M Francis,2 Deodatus Kakoko,3 Patricia Munseri,4 Muhammad Bakari,4 and Eric Sandstrom5
1Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
2National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
3Department of Behavioural Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
4Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
5Venhälsan, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
corresponding authorCorresponding author.
Edith AM Tarimo: etarimo54/at/yahoo.co.uk; Joel M Francis: joelmfrancis/at/gmail.com; Deodatus Kakoko: nkuru/at/yahoo.com; Patricia Munseri: pmunseri/at/yahoo.com; Muhammad Bakari: drbakari/at/yahoo.com; Eric Sandstrom: eric.sandstrom/at/sodersjukhuset.se
Received March 1, 2012; Accepted July 3, 2012.
Abstract
Background
In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03) trial in Dar es Salaam, Tanzania.
Methods
In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data.
Results
Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program.
Conclusions
The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination program may increase its coverage at early childhood. The findings from this investigation provide contextual understanding that may assist in scaling-up male circumcision in Tanzania.
Keywords: Perception, Police officers, Male circumcision, HIV, Tanzania
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