Foreskin cutting beliefs and practices and the acceptability of male circumcision for HIV prevention in Papua New Guinea

• Published in: BMC public health 2013-09, Vol.13 (1), p.818-818, Article 818
• Main Authors: MacLaren, David, Tommbe, Rachael, Mafile'o, Tracie, Manineng, Clement, Fregonese, Federica, Redman-MacLaren, Michelle, Wood, Michael, Browne, Kelwyn, Muller, Reinhold, Kaldor, John, McBride, William John
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; AIDS; Attitude to Health; Child; Circumcision; Circumcision, Male - methods; Circumcision, Male - statistics & numerical data; Collaboration; Colleges & universities; Cross-Sectional Studies; Cultural Characteristics; Culture; Developing Countries; Disease prevention; Female; Foreskin - surgery; Health aspects; Health Behavior; Heterosexuality; HIV; HIV infection; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Male; Males; Methods; Papua New Guinea; Patient Acceptance of Health Care - statistics & numerical data; Penis; Petroleum mining; Prevention; Public Health; Regions; Religion; Risk Assessment; Rural development; Sexually transmitted diseases; Social aspects; Students; Surveys and Questionnaires; Women; Young Adult
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-13-818

Male circumcision (MC) reduces HIV acquisition and is a key public health intervention in settings with high HIV prevalence, heterosexual transmission and low MC rates. In Papua New Guinea (PNG), where HIV prevalence is 0.8%, there is no medical MC program for HIV prevention. There are however many different foreskin cutting practices across the country's 800 language groups. The major form exposes the glans but does not remove the foreskin. This study aimed to describe and quantify foreskin cutting styles, practices and beliefs. It also aimed to assess the acceptability of MC for HIV prevention in PNG. Cross-sectional multicentre study, at two university campuses (Madang Province and National Capital District) and at two 'rural development' sites (mining site Enga Province; palm-oil plantation in Oro Province). Structured questionnaires were completed by participants originating from all regions of PNG who were resident at each site for study or work. Questionnaires were completed by 861 men and 519 women. Of men, 47% reported a longitudinal foreskin cut (cut through the dorsal surface to expose the glans but foreskin not removed); 43% reported no foreskin cut; and 10% a circumferential foreskin cut (complete removal). Frequency and type of cut varied significantly by region of origin (p