Compelling epidemiological evidence showing a significant association between lack of
male circumcision and
HIV infection has prompted calls for consideration of
male circumcision interventions as a strategy for reducing HIV prevalence in highly affected areas where circumcision is little practiced and transmission is predominantly heterosexual. Little is known about whether
male circumcision interventions would be acceptable or feasible in traditionally non-circumcisng areas of Africa. This study assesses the acceptability of
male circumcision in the Luo, a large, traditionally non-circumcising ethnic group in western Kenya. Separate focused group discussions with adult Luo men and women and semi-structured interviews with clinicians were conducted in Nyanza Province, Kenya. The primary barriers to acceptance of
male circumcision were cultural identification, fear of
pain and excessive
bleeding and cost. The main facilitators were association of
male circumcision with better hygiene and reduced risk of
infection. Both men and women were eager for promotion of genital hygiene and
male circumcision, and they desired availability of circumcision clinical services in the Province's health facilities. Clinicians lacked the knowledge and resources to offer safe circumcision counselling and services. If results from this study are valid for other areas of sub-Saharan Africa, acceptability of
male circumcision as a means to reduce
STDs and HIV is higher than previously suspected. Further studies are needed in other regions to assess the feasibility of introducing acceptable
male circumcision information and services to reduce HIV transmission.