3822 : ADOLESCENT MALE CIRCUMCISION: TIMING, PLACE AND MESSAGES FOR RSH

Author(s): 
Grant, Angus
Text: 
Oral Presentation
Research Based
BACKGROUND: The AIDS pandemic of sub Saharan Africa requires multifaceted, targeted work, with emphasis on the emerging youth prior to their becoming sexually active. Meru boys, living in Eastern Province in Kenya are entering a community where cannabis and alcohol are abused, where male violence is common, and where the estimated prevalence of HIV/AIDS in their provincial town runs at 35%. These adolescent boys/men are often difficult to reach, and influence with health and sexual education In the past the Meru, provided such education during initiation ceremonies of circumcision. The teaching about the "ways of men" was provided in a time and space rich with the expectation of change, and newness. This study sought to determine whether traditional circumcision teaching could be adapted to today's needs.
METHODS: We conducted semi structured interviews with 117 adult Meru men, ( 55 guardians of boys being circumcised, two traditional circumcisers, traditionally circumcised local men, and male nurses performing circumcision within the health clinic and hospital setting) regarding past and present circumcision. We interviewed 140 adolescent boys before and after their circumcision. Age and place of circumcision have changed during recent decades, but traditional elements remain. Prior to circumcision young boys are still forbidden by cultural pressure to have sexual relationships. After circumcision and the transition from child to man, sexual engagement is permitted. Boys and their families expect teaching on sexual matters and life skills. They also anticipate that passing through initiation will effect so anticipate a profound life change.
CONCLUSIONS: Circumcision provides the right time, and the right place for giving life changing health messages. The results provided the basis for an educational programme for Meru boys undergoing circumcision. Programme seized the cultural, family and individual expectancy of change. It provided boys with the capacity to make healthy life choices through information giving using different mediums, and through peer support, role models and participatory games. Learning from the past, recognising moments of potential change, facilitating community involvement through culturally appropriate and expected activities ensures participation and openness.
Topic: Health Behaviour Change