Cutting into perceptions : investigating men's understanding of protection - through medical male circumcision for HIV prevention, in Durban, KwaZulu-Natal.

Abstract

Three recent Randomised Controlled Trials (RCTs) have been able to deduce that Medical Male Circumcision (MMC) can reduce a heterosexual man’s chances of acquiring HIV through vaginal sexual intercourse by approximately 60% (Auvert et al. 2005; Gray et al. 2007; Bailey et al. 2007). In 2010, based on WHO recommendations, South Africa commenced a nationwide roll-out of MMC services. However, in the wake of these findings have come concerns that decreases in men’s perceived risk of contracting HIV could spark increases in risky sexual behaviour (risk compensation), in turn, driving up HIV incidence as opposed to abating it (Cassell et al. 2006). Accordingly, the World Health Organisation has identified social change communication as one of the ten key elements critical to the success of a wide scale MMC roll out (WHO & UNAIDS, 2010). Aside from creating demand, the role of MMC health communication efforts in crafting messages delineating the scope of MMC’s protective ability is paramount; especially in South Africa, a country hamstrung by a weak public health sector that can ill afford any regression in the fight against HIV and AIDS. This thesis provides a small-scale qualitative study that investigates both the motivating and discouraging factors impacting on men’s choices to undergo MMC, as well as exploring how and what ‘key messages’ of Medical Male Circumcision media and information initiatives are being received. In this way, my study hopes to bring insight into not only risk compensation associated with MMC, but also to provide a glimpse into the condition of health communication for MMC in the South African context.