Traditional male circumcision is a rite of passage among the AmaXhosa in South Africa. According to the custom of male traditional circumcision, initiates should remain in the bush for the entire seclusion period. The AmaXhosa male initiates encounter complications due to a ritual that has gone wrong. Common complications are penile sepsis, dehydration, penile amputations and septicaemia. As a last resort, when the AmaXhosa male initiates do not improve from complications associated with the custom they are referred to hospital for admission (Meintjes, 1998; Warren-Brown, 1998). The main purposes of this study were, first to explore and describe the delivery of care to the hospitalized AmaXhosa male initiates whilst in the hands of healthcare professionals and professional care system. Second, to describe what constitutes culturally appropriate care for hospitalized AmaXhosa male initiates. This study took place in three research sites, that included one rural hospital and two urban hospitals which admitted the AmaXhosa male initiates of traditional circumcision. A total of 13 hospitalized AmaXhosa male initiates and nine health professionals took part in this study. Leininger's ethnonursing qualitative research approach was used to guide this study. Data were collected, using purposive sampling, by means of unstructured interviews using guides, tape-recorder, and field notes. The study was first piloted at Umlamli Hospital using the same data collecting strategies as for the major study. Data from key and general informants were analysed separately using Leininger's (1991) four-phase method. This was carried out in order to answer the research questions and research purposes. Major themes and patterns emerged from this process. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2016. / IntroductionMale circumcision refers to the surgical removal of all or parts of the prepuce of the penis. This procedure is undertaken for religious, cultural, social, hygiene or medical reasons (Maibvise and Mavundla 2013: 139). The number of people living with Human Immunodeficiency Virus (HIV) rose from approximately 8 million in the year 1990 to 33 million infections now. Sub-Saharan Africa is the region in the world most affected by HIV/AIDS with 22.4 million people living with the virus in the year ending 2008 (Naidoo et al. 2012: 2). The use of male and female condoms remains a challenge despite decades of promotion. There is evidence that medical male circumcision (MMC) is effective in preventing HIV sexual transmission. Medical male circumcision is a drive that was initiated by the National Department of Health as a strategy to curb HIV infection in South Africa in 2010. Aim of the Study The purpose of the study was to investigate and describe knowledge, attitudes and perceptions of males with regard to medical male circumcision. Methodology A quantitative descriptive survey research method was used to describe the knowledge, attitudes and perceptions of males attending the community health care centers (CHCs) in eThekwini district regarding medical male circumcision. Results Displayed posters motivated 71.4% (n = 329) to have circumcisions. While 65.1% (n = 300) respondents had knowledge about circumcision and HIV, 27.8% (n = 280) perceived that circumcision would interfere with their sexual function and reproduction. A total of 38.8% (n = 179) of respondents indicated that it is good for children to be circumcised. There is a significant positive correlation between age and knowledge (r = 0.135, p = .004). Higher age is correlated with more knowledge. Conclusion This study found that knowledge plays a major role in changing attitudes and perceptions. The more knowledgeable an individual is, the more the chance is of them having a positive attitude towards MMC which could also influence a positive perception of MMC. In order to strengthen male circumcision as an HIV prevention strategy, it is imperative to provide the population that reflected low knowledge and negative attitude with information, education and counselling services. This may help them to change their attitudes and acquire a positive perception of MMC. / M

Medical male circumcision prevalence in Lesotho remains at 23% even though efforts are made to encourage men to be circumcised. The purpose of this study was to explore and describe perceptions of men regarding male circumcision in a hospital in Morija, Lesotho and make recommendations on how to promote uptake of medical male circumcision. A descriptive, explorative and contextual qualitative design was used. In-depth, unstructured individual interviews were conducted on ten (10) uncircumcised men who were selected via purposive sampling. The findings revealed that men’s perceptions on circumcision can be classified under the following themes: perceived health beliefs of men about circumcision, perceived community-held beliefs about circumcision, men’s knowledge regarding circumcision, and perceived misconceptions about circumcision. It is recommended that knowledge on circumcision be reinforced and negative perceptions be corrected with the multi-sectoral approach to promote uptake of circumcision services. / Health Studies / M.A. (Public health)

Text in English / Many African countries including Zimbabwe have scaled up and included male circumcision in their comprehensive HIV Prevention package. However, the impact of male circumcision on male sexual function and satisfaction has remained controversial. The main purpose of the study was to investigate the impact of male circumcision on sexual function and satisfaction in Harare, Zimbabwe. A quantitative study was carried out amongst a sample of 169 circumcised men using a questionnaire. The results showed that circumcision has a positive effect on both male sexual function and satisfaction. It was concluded that undergoing voluntary medical male circumcision have a high degree of satisfaction with the procedure and its consequences in terms of sexual function and satisfaction. It was recommended that men are educated about these findings so as to clear myths and misconceptions around circumcision. / Health Studies / M.P.H.

The practise of male traditional circumcision is severely challenged with enormous problems ranging from hospitalisation of the initiates as well as deaths of the initiates. The background of the problem is focused in the Eastern Cape Province where the researcher has noted several initiates being treated in hospitals for physical and as well for psychological problems. The objective of this study was to explore and describe newly initiated Xhosa men's experiences of traditional circumcision rites at East London in the Eastern Cape Province and to describe the guidelines for support of these newly initiated Xhosa men by public health professionals. A qualitative explorative, descriptive contextual and phenomenological design was followed. Purposive sampling technique was used to select the participants. Fourteen participants volunteered to participate in the study after they met the eligible criteria. Focused group interviews were used as a method for data collection. Data analysis of the study showed that there are several factors affecting newly initiated men whilst undergoing circumcision rites. These factors can present at any of the three circumcision stages i.e. pre-circumcision, peri-circumcision and post-circumcision. The recommendations of the study strongly suggest a cultural competence in rendering effective health care services to culturally and ethnically diverse clients. All the five constructs of cultural competence are entailed in the support guidelines that have been developed by the researcher. They are cultural awareness, cultural knowledge, cultural skill, cultural encounter and cultural desire. Finally limitation of the study and the need for a further research has been clearly stated. / Health Studies / M.A.

Research studies have revealed that male circumcision (MC) reduces the transmission of HIV infection from infected women to circumcised men by up to 60% (UNAIDS 2007:2), hence the adoption of MC as an HIV-infection prevention strategy by the United Nations (WHO 2007:2). Botswana, a sub-Saharan African (SSA) country, has HIV as a leading health and developmental challenge. The government adopted male circumcision as one of the strategies to combat the infection. Apparently, not all tribes in Botswana practise male circumcision as part of their culture. The purpose of this study was to develop and describe a model for HIV-infection prevention using MC. Three theory-generating research objectives were used to develop the model, namely to explore and describe perceptions of men regarding the use of MC, to develop and describe a model for MC service delivery, and to develop and describe guidelines for service providers to facilitate delivery of MC. A theory-generating research design which is qualitative, exploratory, descriptive, and contextual was used to develop the model in three phases. Phase 1 involved concept identification, concept definition, and concept classification. Data was collected using focus group discussions and individual in-depth interviews among 38 men aged 18-49 years and analysed according to recommendations made by Tesch (1990), as cited in Creswell (2009:186). Four themes emerged in the study, namely perceived effects on values, perceived source and provision of information, perceived knowledge of benefits of male circumcision, and perceived risks of male circumcision. The concept of “culture congruence” was derived from the themes as the main concept for the development of a “culture-congruent MC model for HIV prevention”. Phase 2 involved a description of the structure and the process of the model, by organising the concepts in relation to one another. The model was also evaluated. Phase 3 of the model involved the development of guidelines to support health service providers to provide MC services in a culture-congruent way in preventing HIV infection. Recommendations made were incorporation of transcultural health care instruction in nursing and medicine curricula, research on secondary audiences, such as women, and application of a culture-congruent MC model among diverse cultures. / Health Studies / D. Litt. et Phil. (Health Studies)

Research studies have revealed that male circumcision (MC) reduces the transmission of HIV infection from infected women to circumcised men by up to 60% (UNAIDS 2007:2), hence the adoption of MC as an HIV-infection prevention strategy by the United Nations (WHO 2007:2). Botswana, a sub-Saharan African (SSA) country, has HIV as a leading health and developmental challenge. The government adopted male circumcision as one of the strategies to combat the infection. Apparently, not all tribes in Botswana practise male circumcision as part of their culture. The purpose of this study was to develop and describe a model for HIV-infection prevention using MC. Three theory-generating research objectives were used to develop the model, namely to explore and describe perceptions of men regarding the use of MC, to develop and describe a model for MC service delivery, and to develop and describe guidelines for service providers to facilitate delivery of MC. A theory-generating research design which is qualitative, exploratory, descriptive, and contextual was used to develop the model in three phases. Phase 1 involved concept identification, concept definition, and concept classification. Data was collected using focus group discussions and individual in-depth interviews among 38 men aged 18-49 years and analysed according to recommendations made by Tesch (1990), as cited in Creswell (2009:186). Four themes emerged in the study, namely perceived effects on values, perceived source and provision of information, perceived knowledge of benefits of male circumcision, and perceived risks of male circumcision. The concept of “culture congruence” was derived from the themes as the main concept for the development of a “culture-congruent MC model for HIV prevention”. Phase 2 involved a description of the structure and the process of the model, by organising the concepts in relation to one another. The model was also evaluated. Phase 3 of the model involved the development of guidelines to support health service providers to provide MC services in a culture-congruent way in preventing HIV infection. Recommendations made were incorporation of transcultural health care instruction in nursing and medicine curricula, research on secondary audiences, such as women, and application of a culture-congruent MC model among diverse cultures. / Health Studies / D. Litt. et Phil. (Health Studies)

The practise of male traditional circumcision is severely challenged with enormous problems ranging from hospitalisation of the initiates as well as deaths of the initiates. The background of the problem is focused in the Eastern Cape Province where the researcher has noted several initiates being treated in hospitals for physical and as well for psychological problems. The objective of this study was to explore and describe newly initiated Xhosa men's experiences of traditional circumcision rites at East London in the Eastern Cape Province and to describe the guidelines for support of these newly initiated Xhosa men by public health professionals. A qualitative explorative, descriptive contextual and phenomenological design was followed. Purposive sampling technique was used to select the participants. Fourteen participants volunteered to participate in the study after they met the eligible criteria. Focused group interviews were used as a method for data collection. Data analysis of the study showed that there are several factors affecting newly initiated men whilst undergoing circumcision rites. These factors can present at any of the three circumcision stages i.e. pre-circumcision, peri-circumcision and post-circumcision. The recommendations of the study strongly suggest a cultural competence in rendering effective health care services to culturally and ethnically diverse clients. All the five constructs of cultural competence are entailed in the support guidelines that have been developed by the researcher. They are cultural awareness, cultural knowledge, cultural skill, cultural encounter and cultural desire. Finally limitation of the study and the need for a further research has been clearly stated. / Health Studies / M.A.