Traditional male circumcision and the risk of HIV transmission in Chavuma District,North Western Province,Zambia

Abstract

It has been found that circumcised men are less than half likely to be infected by HIV as uncircumcised men. However, there are also chances that HIV infection can be transmitted at traditional male circumcision due to sharing a bloodcontaminated surgical knife among initiates.This study aims to establish the aspects of traditional male circumcision and the risk of HIV transmission to boys. It also aims to establish the knowledge of male parents, traditional leaders and traditional circumcisers about HIV transmission at traditional male circumcision rites. Further, it seeks to determine whether HIV sensitization has led to safe practice at traditional male circumcision rites to prevent transmission of HIV infection and to identify factors influencing safety of traditional male circumcision against the HIV virus. The study used qualitative methods to collect data using interviews. Data was collected among the Luvale in Chavuma district in Northwestern Zambia. The data was analyzed manually.The study revealed that the majority of the respondents knew what HIV/AIDS was and the routes of transmission. Some respondents knew HIV could be transmitted at male circumcision. Others could not correlate HIV transmission through MTCT and transmission at circumcision. Some traditional circumcisers could not believe sharing a surgical knife between initiates at circumcision could transmit HIV because they wipe it with a cloth before re-using it. They actively used the traditional method of using one surgical knife on all the initiates pausing risk of HIV transmission among them. There were no trained health workers in most health centres in Chavuma district in North Western province to perform male circumcisions except for Chavuma Mission Hospital and Lukolwe rural health centre that had a classified daily employee (CDE) each. There was no active programme dealing with prevention of HIV transmission at male circumcision in the area.Some parents and traditional leadership were opposed to altering the rite because it would compromise their traditional heritage but appealed that the traditional male circumcisers be trained in safe circumcision in order to prevent HIV infection at such a rite.Among the Luvale, the mukanda serves as the training ground for life skills and it is also a channel for receiving ancestral blessings and power. Manhood to the Luvale men therefore entails enduring hardship in life and building up courage to face challenges in life. Circumcision sets apart a Luvale man from women and uncircumcised men. Circumcision through mukanda is the symbol that marks the end of childhood and sets the beginning of the masculine status. Therefore, attaining manhood through circumcision appears much more important than the possible risk of contracting HIV infection at traditional circumcision. The sharing of a surgical knife carries traditional significance. It creates a bond among the peers for the rest of their lives that they shared blood.