More than just a cut: a qualitative study of penile practices and their relationship to masculinity, sexuality and contagion and their implications for HIV prevention in Papua New Guinea

BMC International Health and Human Rights

Andrew Vallely³  Peter Siba¹  John M Kaldor³  Peter S Hill²  Lisa Fitzgerald²  James Neo¹  Herick Aeno¹  Richard Nake Trumb¹  Martha Kupul¹  Angela Kelly⁴ 

[1] Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea;School of Population Health, University of Queensland, Brisbane, Australia;Kirby Institute, University of New South Wales, Sydney, Australia;International HIV Research Group, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia

关键词: Cultural meaning;    Contagion;    Sexuality;    Masculinity;    Penile practices;    Male circumcision;    Papua New Guinea;    HIV;   

Others  :  856566
DOI  :  10.1186/1472-698X-12-10

 received in 2011-12-02, accepted in 2012-06-27,  发布年份 2012

【 摘 要 】

Background

Male circumcision (MC) has been shown to reduce vaginal transmission of HIV to men. While community acceptability is important in a countries preparedness to introduce MC, it is equally important to map contemporary MC and other penile cutting practices, and the socio-cultural dimensions underpinning these practices.

Methods

A total of 482 men and women (n = 276 and n = 210, respectively) participated in 82 semi-structured and 45 focus group discussions from four different provinces of Papua New Guinea (PNG), each representing one of the four socially and geographically diverse regions of the country.

Results

Of the men interviewed 131 self-reported that they had undergone a penile alteration with some reporting multiple types. Practices were diverse and could be grouped into five broad categories: traditional (customary) penile cutting; contemporary penile cutting; medical circumcision; penile inserts; and penile bloodletting practices in which sharp objects are used to incise the glans and or inserted and withdrawn from the male urethra or in order to induce bleeding. Socio-cultural traditions, enhanced sexual pleasure and improved genital hygiene were key motivators for all forms of penile practices.

Conclusions

The findings from this study highlight the complex and diverse nature of penile practices in PNG and their association with notions of masculinity, sexuality and contagion. Contemporary penile practices are critical to a community’s acceptance of MC and of a country’s ability to successfully implement MC in the context of a rich and dynamic culture of penile practices. If a MC program were to be successfully rolled out in PNG to prevent HIV it would need to work within and build upon these diverse cultural meanings and motivators for penile practices already commonly performed in PNG by men.

【 授权许可】

   
2012 Kelly et al.; licensee BioMed Central Ltd.

【 图 表 】

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