The Unpeeled Mango

Publish Date: May 2011
Author: Marya Plotkin, Hawa Mziray, Jan Küver, Judith Prince, Kelly Curran, Hally Mahler
Language: English

Men’s decisions about seeking voluntary medical male circumcision (VMMC) services are complex, influenced by culture, education, sexuality, gender relations, marital status, and exposure to urban or modern culture, among other factors.

This qualitative assessment was conducted in February 2011 in three districts of Iringa region to inform the VMMC program implemented in Iringa, Tanzania, by the Ministry of Health and Social Welfare, with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through MCHIP. This formative work aimed to improve the understanding of the attitudes and beliefs of adult men and women that may enhance or hinder uptake of male circumcision (MC) in Iringa region and explore their people’s views on service delivery.

Although the VMMC program is still relatively new, only 20% of recent MC clients were aged 20 and above. VMMC for HIV prevention will have the greatest immediate impact if adult males are also accessing MC services. The need to promote MC in men over 20 years of age is supported by the fact that HIV prevalence is highest in men ages 35–39 in Tanzania (THMIS 2009).

One hundred and forty-two men and women in the three districts participated in 13 focus
group discussions and three participatory exercises, which included creation of timelines and seasonal calendars. The majority of the participants could accurately describe VMMC and its benefits, including biological ones such as cleanliness, and disease prevention (including HIV/AIDS prevention), as well as perceived ones such as perceptions of increased virility.

Despite the potential barriers identified in this report, the authors believe that with some changes to service delivery, it will be possible to attract more adult males to MC for HIV prevention services.

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