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

Research Article

John M Kaldor¹  Lisa Fitzgerald²  Peter S Hill²  Herick Aeno³  James Neo³  Martha Kupul³  Richard Nake Trumb³  Peter Siba³  Angela Kelly⁴  Andrew Vallely⁵ 

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

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

DOI  :  10.1186/1472-698X-12-10

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

来源: Springer

【 摘 要 】

BackgroundMale 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.MethodsA 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.ResultsOf 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inserts; and penile bloodletting practices in which sharp objects are used to incise the glans and or inserted and withdrawn from the male urethra or in order to induce bleeding.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.ConclusionsThe 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】

CC BY   
© Kelly et al.; licensee BioMed Central Ltd. 2012