MRC PhD student

Level of study: PhD

Title: Traditional male initiation and circumcision in the Eastern Cape Province, South Africa: The utilization and evaluation of health standards to prevent HIV infection

Brief description of the project
The HIV epidemic in South Africa has become feminized. While there have been many programs targeting the health and sexual behaviour of women, there are a limited number of interventions targeting men and their direct contribution to the spread of HIV. Male circumcision has been found to have a protective factor of reducing HIV transmission by between 50 - 60 % in three randomized clinical trials (RCTs) conducted in South Africa, Uganda and Kenya. In the Eastern Cape Province of South Africa, male circumcision is commonly practiced within the context of a rite of passage to adulthood as part of a cultural and traditional belief system. Before circumcision, boys gradually embark on initiation processes that vary from families, communities, ethnic groups and nations. If male circumcision is to be rolled out as a standard HIV prevention strategy in Sub-Saharan Africa as proposed by WHO and UNAIDS, a subsequent educational component will be required to curb risky behaviours associated with young people. In order to explore initiation and male circumcision in the cultural context the Medical Research Council entered into a working partnership with the Eastern Cape House of Traditional Leaders

Specific aims of the project:

• To explore the roles, practices and experiences of various stakeholders, such as amakhosi (kings), iingcibi (traditional surgeons) amakhankhatha (traditional caregivers) in traditional initiation rituals.
• To investigate the medical response to Traditional Circumcision Practices: An attempt to protect Young Men
• To evaluate the training of iingcibis on safe practices to prevent HIV infection
• To document the extent to which initiates under the jurisdiction of the chiefs in the rural parts of EC are complying with regulations designed to protect their health during the circumcision process

Co-Supervisors: Prof P Reddy & Prof. B. van den Borne              
Mentor: Dr R. Ruiter
Support: MRC/DST Professional Development Programme (PDP)
Study Institution: Universiteit Maastricht
MRC Unit: Health Promotion Research & Development Unit