Key considerations in scaling up male circumcision in Tanzania: views of the urban residents in Tanzania|
FRANCIS, JOEL M.; KAKOKO, DEODATUS; TARIMO, EDITH A.M.; MUNSERI, PATRICIA; BAKARI, MUHAMMAD & SANDSTROM, ERIC
Male circumcision (MC) reduces the risk of sexually transmitted infections (STI) including
HIV. The WHO and UNAIDS recommend male circumcision as an additional intervention to prevent
HIV infection. Tanzania is embarking on activities to scale up safe male circumcision for HIV
prevention and other related health benefits. In line with this, it is crucial to assess views of the
population using specific groups. This paper describes perceptions on male circumcision and
strategies of enhancing uptake of male circumcision in urban Tanzania using members of the police
force. This cross sectional survey was conducted among members of the police force in Dar es Salaam
Tanzania from January 2010 to July 2010. The police officer serves as a source of the clinical trial
participants in on-going phase I/II HIV vaccine trials. Three hundred and thirteen (313) police officers
responded to a self-administered questionnaire that comprised of socio-demographic characteristics,
reasons for not circumcising, perceptions regarding circumcision, methods of enhancing male
circumcision, communication means and barriers to promote circumcision. This was followed by a
physical examination to determine male circumcision status. The prevalence of circumcision was 96%.
Most (69%) reported to have been circumcised in the hospital. The reported barriers to male
circumcision among adults and children were: anticipation of pain, cost, fear to lose body parts, and
lack of advice for adult’s circumcision. Sensitization of parents who take children to the reproductive
and child health services was recommended by most respondents as the appropriate strategy to
promote male circumcision. The least recommended strategy was for the women to sensitize men.
Use of radio programs and including male circumcision issues in school curricula as means of
enhancing community sensitization regarding male circumcision were also highly recommended.
Other recommendations include use of public media, seminars at work and issuance of circumcision
regulations by health authorities. In conclusion, the present study reveals male circumcision was
common in a selected urban population. There are various barriers and channels of communication
regarding male circumcision. In view of scaling male circumcision in Tanzania, use of radio messages,
inclusion of male circumcision in the school curricula and sensitization at the reproductive and child
health clinics are likely to promote early medical male circumcision.
Male circumcision; barriers; perception; police officers; Tanzania