Male Circumcision Research

The Tonga tribe dominate the Southern Province of Zambia where Mazabuka is one of the major towns in the area. In terms of HIV and AIDS activities two important Tonga customs play a significant influencing role in the epidemic. Sexual networks, or multiple concurrent partners, are where a person has a sexual partner but then one or both of those partners also have other sexual partners. Then these other individuals may have more than one sexual partner themselves, hence the networks grow and the risk of someone becoming infected with HIV is much greater if these sexual relationships are all being carried out at the same time. In ‘Tonga-land’ polygamy is part of the custom and multiple concurrent partnerships are not illegal. The phrase ‘Tonga bull’ is often mentioned by men where they are proud to be engaging sexually with more than one woman at the same time.

The second HIV and AIDS issue is that across Zambia the rate of male circumcision is low – men are traditionally not circumcised either at birth or as part of the rights of passage to manhood. There are exceptions such as in the North Western part of Zambia where for the Luvale tribe around 71% of men are circumcised. However, in the Southern Province the figure is only 4%. Studies are shown that male circumcision can reduce HIV infections by up to 60% (beneficial though still not the level of protection offered by wearing a condom but availability, access and then the actual wearing of condoms remains a major challenge).

I am giving this bit of background because one HIV and AIDS stakeholder in Mazabuka, Women Empowerment Alliance (a small community based organisation), was awarded funding to carry out some research in Mazabuka concerning the acceptability of male circumcision in the area. They want to interview around 1,000 people in rural, peri-urban and urban areas of the district to try and understand what people already know about male circumcision, their views on the advantages and disadvantages, who should carry out the operations and what challenges or issues exist at the moment which would affect the take-up of male circumcision in this area. So I have been helping them to design the questionnaire, train the researchers and then go out in the field (briefly) to get a sense of how people are responding to our questions; the hard work of the 1,000 interviews has been left to the interview team. Aside from it being good to be out doing some research work, the results could potentially be both interesting and very useful for policy making. The next challenge will be the data entry and analysis . . .