Acceptability of Medical Male Circumcision and Improved Instrument Sanitation Among a Traditionally Circumcising Group in East Africa

By removing the foreskin, medical male circumcision (MMC) reduces female to male heterosexual HIV transmission by approximately
60 %. Traditional circumcision has higher rates of complications than MMC, and reports indicate unsanitized instruments are
sometimes shared across groups of circumcision initiates. A geographically stratified, cluster survey of acceptability of
MMC and improved instrument sanitation was conducted among 368 eligible Maasai participants in two Northern Districts of Tanzania.
Most respondents had been circumcised in groups, with 56 % circumcised with a shared knife rinsed in water between initiates
and 16 % circumcised with a knife not cleaned between initiates. Contrasting practice, 88 % preferred use of medical supplies
for their sons’ circumcisions. Willingness to provide MMC to sons was 28 %; however, provided the contingency of traditional
leadership support for MMC, this rose to 84 %. Future interventions to address circumcision safety, including traditional
circumciser training and expansion of access to MMC, are discussed.