Magister Artium (Medical Anthropology) - MA(Med Ant) / This research study investigates Xhosa men’s perceptions of voluntary medical male circumcision (VMMC) in Khayelitsha township (Cape Town). It explored whether the introduction of VMMC as a state HIV-prevention strategy had engendered shifts in constructions of masculinity and negative perceptions of men who had undergone VMMC. Previously traditional male circumcision (ulwaluko) was the preferred form of circumcision among amaXhosa and medical male circumcision (MMC) was viewed as alien to Xhosa culture. Xhosa-speaking men who had undergone MMC were stigmatised by peers and viewed as not being ‘real men’. VMMC has the potential to shift constructions of masculinity based on circumcision status. An ethnographic research study was carried out using qualitative research methods, including participant observation, individual interviews and focus group discussions. Data collection occurred over a 6-month period in the Mandela Park community, at Michael Maphongwana Clinic, and at a male initiation school. The study found that ulwaluko remains a definitive marker of masculine Xhosa identity and is still informed by culture and tradition. Despite VMMC, men who undergo ulwaluko continue to perceive men who choose MMC as ‘the other’ and not as ‘real men’. The study highlighted that VMMC advocates need to take cognisance of traditional notions of masculinity and address negative perceptions of men in Xhosa-speaking communities who have undergone VMMC.

L'effet protecteur de la circoncision masculine (CM) contre l'acquisition hétérosexuelle du VIH chez les hommes a été démontré dans trois essais contrôlés randomisés menés en Afrique australe et de l'Est, et sa généralisation a été recommandée par l’OMS et l’ONUSIDA comme une composante complémentaire importante des stratégies de prévention du VIH dans les pays à forte incidence du virus et bas taux de CM. Cependant, la généralisation de la CM dans les communautés ou elle n’est pas une norme sociale pose de nombreux défis en ce qui concerne son acceptabilité, son implémentation, son acceptation et son impact sur les comportements sexuels ainsi que sur les connaissances, attitudes et pratiques concernant la CM. Le projet ANRS 12126 Bophelo Pele a été implémenté à la suite des recommandations internationales dans la communauté d’Orange Farm, en Afrique du Sud, site du premier essai randomisé contrôlé sur la CM, et communauté cible de cette stratégie. Les activités de recherche menées au sein du projet prouvent que la généralisation de la CM est acceptable et réalisable rapidement dans une communauté à ressources limitées, selon les directives des instances internationales, de manière sure et coût-efficace. Son acceptation parmi les hommes non-circoncis est satisfaisante. De plus, trois ans après l’implémentation du projet, et bien que les connaissances envers la CM et son effet sur le risque du VIH restent à être améliorées, aucune différence de comportement sexuel n’a été décelée entre les hommes circoncis et les hommes non-circoncis ainsi qu’entre les partenaires des hommes circoncis et celles des hommes non-circoncis. La CM comme méthode de prévention du VIH dans les communautés hyperendémiques est donc une stratégie qui promet d’avoir un impact considérable sur l’épidémie en Afrique australe et de l’Est. / The protective effect of male circumcision (MC) on HIV heterosexual acquisition among men was demonstrated in three randomized controlled trials conducted in Southern and Eastern Africa, and its roll-out has been recommended by the WHO and UNAIDS as an important complementary component of HIV prevention strategies in high incidence communities with low rates of MC. However, the scale-up of MC in communities where it is not a social norm raises several challenges in regards to its acceptability, its implementation, its uptake, and its impact on sexual behavior as well as knowledge, attitudes and practices about MC. The ANRS 12126 Bophelo Pele project was implemented following the international recommendations in the community of Orange Farm (South Africa), site of the first MC randomized controlled trial, and target community of this strategy. Research activities conducted to evaluate the project show that the roll-out of MC is acceptable and can be implemented quickly in limited resources settings according to international recommendations in a safe and cost-effective manner. MC uptake among uncircumcised men is satisfactory. In addition, three years after project implementation, no difference in sexual behavior between circumcised men and uncircumcised men and between female partners of circumcised and uncircumcised men was detected, although knowledge and attitudes about MC and its association with HIV could be improved. MC as an HIV prevention method in hyperendemic communities is a promising strategy which can have a considerable impact on the epidemic in Eastern and Southern Africa.

Trois essais randomisés contrôlés ont démontré le rôle protecteur de la circoncision dans l'acquisition hétérosexuelle du VIH par les hommes. A la suite de ces essais, l'Organisation mondiale de la santé (OMS) et le Programme commun des Nations Unies sur le VIH/SIDA (ONUSIDA) ont recommandé que des programmes de circoncision volontaire médicalement encadrée (CVME) soient déployés dans les pays où la prévalence du VIH est forte et où peu d'hommes sont circoncis. Par ailleurs, L'OMS recommande une prévalence de la circoncision d’au moins 80% chez les adultes pour avoir un impact substantiel sur l'épidémie de VIH/SIDA en Afrique orientale et australe.Débutés en 2007 dans quatorze pays prioritaires de cette région, les programmes de promotion de la CVME ont permis une augmentation rapide de la prévalence de la circoncision à environ 50% en 2011.L’étude a été conduite à Orange Farm (Afrique du Sud) où un programme de promotion de la CVME similaires à ceux conduits dans les autres pays d’Afrique australe et orientale est en cours depuis 2007. Elle montré que la prévalence de la circoncision a augmenté de 12% à 53% entre 2007 et 2011, et qu'elle est restée stable depuis.Ensuite une stratégie novatrice conçue, basée sur l'information, les entretiens motivationnels, les discussions dans des foyers et une compensation financière a été testée à Orange Farm. Cette intervention a permis d’atteindre une prévalence de la circoncision de plus de 80% dans un temps court. Cette stratégie devrait être aisément adaptable à un autre contexte que celui de l'Afrique du Sud pour augmenter la prévalence de la circoncision à plus 80% en Afrique orientale et de diminuer l'incidence du VIH. / Three randomized controlled trials showed the protective role of circumcision in heterosexual HIV transmission. The World Health Organization (WHO) and the Joint United Nations Program on AIDS (UNAIDS) recommend that voluntary male medical circumcision (VMMC) programs should be rolled-out wherever there is a generalized HIV epidemic and few men are circumcised. WHO recommends a prevalence rate of at least 80% male circumcision in adults to have a substantial impact on the HIV/AIDS epidemic in Eastern and Southern Africa. Starting in 2007 in the fourteen Southern and Eastern Africa countries identified as priority countries, the programs to promote the CVME have allowed a rapid increase of the male circumcision prevalence rate. So very low in 2008, it rose to about 50% in 2011. This study showed that the male circumcision prevalence has remained almost stable among adults in the township of Orange Farm since 2011. Township where a similar promotion program to other Southern and Eastern African countries is underway since 2007. We then designed and tested an innovative strategy combining the existing strategy with the elements of interpersonal communication with a financial compensation and discussions with all members of the household. This new strategy tested showed that a male circumcision prevalence rate of 80% could be obtained in a very short time. This easily reproducible method should be encouraged in order to increase the male circumcision prevalence rate to 80% as recommended by WHO in severely HIV affected countries, and thus to decrease HIV incidence.

The aim of this work is to familiarize the reader more closely with the issue of male circumcision in ancient Egypt and ancient Israel, and subsequently also in Judaism, and to outline how the theme of Jewish circumcision was adapted by Christianity. It describes the custom of male circumcision in ancient Egypt using pictorial and textual evidence, including findings on mummies. It looks for similarities and differences between male circumcision in ancient Egypt and in Judaism, in which it represents one of the most important rituals, and a sign of belonging to God and the nation. Attention is also given to the significant transformation in Christianity to the new initiation ritual of baptism, and opinions damning circumcision. Biblical themes, including the mystery of Jesus' circumcision and Christ's crucifixion, are reflected in European visual art, which is discussed in the final part of the work. Powered by TCPDF (www.tcpdf.org)

Magister Public Health - MPH / Voluntary Medical Male Circumcision (VMMC) has been proven to reduce heterosexual HIV transmission to men by approximately 60%. It has been argued that achieving 80% circumcision coverage among males aged 15–49 years within five years and maintaining this coverage rate in subsequent years, could avert 3.4 million new HIV infections within 15 years and generate treatment and care savings of US$16.5 billion. As a result the South African Government plans to circumcise 4.3 million males aged 15 and 49 years by the 2015/2016 financial year. However, in the Western Cape the uptake for circumcision has been poor. While there is not a great deal of knowledge out there about the reasons for the uptake (or lack thereof) of VMMC in the Western Cape, current research focus on Xhosa males predominantly. However, there is limited research on circumcision among the "Coloured" population of the Western Cape. As the "Coloured" population is the largest group in the Western Cape, this gap in research and knowledge is worth noting. The current study aimed to explore the barriers to and enablers of uptake of VMMC among "Coloured" males between the ages of 15 and 49 years in the Cape Town Metropolitan Municipality. Methodology: The study adopted a qualitative design; semi-structured interviews were conducted with seven key informants, and two focus group discussions with men who had undergone VMMC and men who had chosen not to volunteer to undergo VMMC. Thematic analysis was used to analyse the data. Results: The key enablers to uptake of VMMC were: the desire for improved hygiene; the reduction in the risk of contracting other STIs; the reduction in the risk of contracting HIV; the role of partners and family members who can encourage males to access services; the perceived improvement in the males' sexual experience and performance; and cultural reasons and religious injunction. On the other hand the key barriers that discouraged "Coloured" participants from accessing the services include: fear, particularly the fear of pain; the experience of the health services and the role of health staff; the six week healing period in which males cannot have sex; the unwillingness to alter the body that they were born with; role of partners and family as discouragers of uptake; the influence of gangsterism on the ability of males to access services offered on a different gang's 'turf'; and, substance abuse. The recommendations in this study focus largely on the need to expand the coverage of VMMC in the Cape Town Metropolitan Municipality and to increase the uptake among "Coloured" males between the ages of 15 and 49 years. . These recommendations essentially involve the need to break down the barriers and to accentuate the enablers. To this end social mobilisation campaigns should not focus solely on HIV prevention but rather on hygiene and improved sexual experience and appearance as well as the cultural and religious aspects. With regard to the barriers it is essential that any social mobilisation engages with the fear of pain. On method to do this would be through the introduction and expansion of the PrePex™ device. The fear that circumcision could impact on sexual performance and the fear of embarrassment and discomfort the whole process would potentially bring would need to be allayed. In addition it is essential that the health services and health staff are orientated and trained in a way that ensures that the process of circumcision is as easy as possible for the clients. / National Research Foundation

The purpose of the thesis is to analyze the arguments presented by the Center party (Centerpartiet) and the Moderate party (Moderaterna) in two motions regarding a ban on male circumcision. The public discussion about non-medical male circumcision surfaced in the autumn of 2019, when the Center party decided to strive a ban on male circumcision during their congress meeting.   The study's questions were: What arguments are used to legislate a ban on male circumcision? How can the motions be understood as a form of politicization of religion? Is religion portrayed as an object or subject? Is religion presented as a resource or a problem? Using qualitative argumentation analysis, the content of two motions, one from the Center Party and one from the Moderates, as well as opinions on these motions from district boards, federal boards and party leaders, were examined and analyzed based on the theory politicization of religion. The results showed that religion was mainly presented as an object, meaning religion was referred to but there was no dialogue with religious leaders, figures or communities. Based on the analysis, religion was presented both as a resource and a problem, however it was more frequently presented as a problem than as a resource.

A quantitative and descriptive type of study design was followed using structured self-administered questionnaires distributed among 84 conveniently selected male adolescent learners from Nanogang Community Junior Secondary School (NCJSS) in Gaborone. The purpose of this study was to describe factors that influence the uptake of safe male circumcision (SMC) as a human immune-deficiency virus (HIV) prevention strategy among male adolescent learners. The study findings show that protection from HIV and other sexually transmitted infections (STIs) was found to be the main reason for adolescent learners undergoing male circumcision (MC) (p<.01). Reasons such as maintenance of genital hygiene, culture, religion, and the enhancement of sexual pleasure were not found to be significant factors. Misconceptions such as the belief that girls do not like circumcised partners were found to be the main reason for adolescent learners not undergoing MC (p<.05). A number of factors which were claimed in previous studies to be obstacles for the uptake of MC, such as surgical complications, peer pressure, stigma, and discrimination, were not found to be major obstacles / Health Studies / M.A. (Public Health)

A quantitative and descriptive type of study design was followed using structured self-administered questionnaires distributed among 84 conveniently selected male adolescent learners from Nanogang Community Junior Secondary School (NCJSS) in Gaborone. The purpose of this study was to describe factors that influence the uptake of safe male circumcision (SMC) as a human immune-deficiency virus (HIV) prevention strategy among male adolescent learners. The study findings show that protection from HIV and other sexually transmitted infections (STIs) was found to be the main reason for adolescent learners undergoing male circumcision (MC) (p<.01). Reasons such as maintenance of genital hygiene, culture, religion, and the enhancement of sexual pleasure were not found to be significant factors. Misconceptions such as the belief that girls do not like circumcised partners were found to be the main reason for adolescent learners not undergoing MC (p<.05). A number of factors which were claimed in previous studies to be obstacles for the uptake of MC, such as surgical complications, peer pressure, stigma, and discrimination, were not found to be major obstacles / Health Studies / M.A. (Public Health)

<p>In South Africa the practice of virginity testing is most prevalent in KwaZulu-Natal amongst the Zulu and Xhosa. Proponents of the practice claim that some of the benefits include the prevention of the spread of HIV/Aids as well as teenage pregnancy and the detection of children who are sexually abused by adults, amongst others. In South Africa most black males undergo an initiation when they are approximately 16 years old to mark the transition from boyhood to manhood. Male circumcision is also performed as a religious practice amongst the Jews and Muslims.</p> <p>A number of human rights groups in South Africa, including the Commission on Gender Equality (CGE) as well as the South African Human Rights Commission (SAHRC) has called for a total ban on the practice of virginity testing on the basis that it discriminates against girls, as the practice is carried out predominantly amongst teenage girls. The CGE and SAHRC are particularly concerned about the potential for human rights violations of virginity testing.</p> <p>The problem with traditional male circumcisions in South Africa is the number of fatalities resulting from botched circumcisions and the spreading of sexually transmitted diseases through unhygienic procedures and unqualified surgeons. Also of concern are other hardships often accompanied by traditional circumcisions such as starvation, frostbite, gangrene and infection amongst other health related injuries. Thus, according to human rights activists, when carried out in these circumstances, traditional male circumcisions have the potential to violate a number of rights aimed at protecting boys including the right to physical integrity and life, in cases of the death of an initiate.</p> <p>South Africa has also ratified a number of international treaties aimed at protecting children against harmful cultural practices such as the United Nations Convention on the Rights of the Child (CRC), the African Charter on the Rights and Welfare of the Child and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). As such it has been argued by rights groups that virginity testing as well as male circumcisions carried out in the conditions set out above have the potential to violate a number of provisions contained in international instruments aimed at protecting the dignity of children.</p>

<p>In South Africa the practice of virginity testing is most prevalent in KwaZulu-Natal amongst the Zulu and Xhosa. Proponents of the practice claim that some of the benefits include the prevention of the spread of HIV/Aids as well as teenage pregnancy and the detection of children who are sexually abused by adults, amongst others. In South Africa most black males undergo an initiation when they are approximately 16 years old to mark the transition from boyhood to manhood. Male circumcision is also performed as a religious practice amongst the Jews and Muslims.</p> <p>A number of human rights groups in South Africa, including the Commission on Gender Equality (CGE) as well as the South African Human Rights Commission (SAHRC) has called for a total ban on the practice of virginity testing on the basis that it discriminates against girls, as the practice is carried out predominantly amongst teenage girls. The CGE and SAHRC are particularly concerned about the potential for human rights violations of virginity testing.</p> <p>The problem with traditional male circumcisions in South Africa is the number of fatalities resulting from botched circumcisions and the spreading of sexually transmitted diseases through unhygienic procedures and unqualified surgeons. Also of concern are other hardships often accompanied by traditional circumcisions such as starvation, frostbite, gangrene and infection amongst other health related injuries. Thus, according to human rights activists, when carried out in these circumstances, traditional male circumcisions have the potential to violate a number of rights aimed at protecting boys including the right to physical integrity and life, in cases of the death of an initiate.</p> <p>South Africa has also ratified a number of international treaties aimed at protecting children against harmful cultural practices such as the United Nations Convention on the Rights of the Child (CRC), the African Charter on the Rights and Welfare of the Child and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). As such it has been argued by rights groups that virginity testing as well as male circumcisions carried out in the conditions set out above have the potential to violate a number of provisions contained in international instruments aimed at protecting the dignity of children.</p>