Women as Agents of Change: Male Circumcision and HIV Prevention in Kenya

Abstract

The recent promotion of male circumcision as a public health strategy is based on research evidence from three randomised control trials conducted in South Africa, Kisumu in Kenya, and Rakai in Uganda. The evidence suggests that male circumcision provides heterosexual men 50–60% protective benefit against HIV infection. For the Kikuyu people in Kenya, male circumcision is a cultural rite of passage from childhood to adulthood. The focus of this study was male circumcision practices in Muranga of Kenya and their implications on public health. There is a paucity of studies and reports on cultural practices of male circumcision in Kenya. This article discusses male circumcision meaning and associated changes with a central focus on women. A qualitative research design underpinned by an Interpretivist paradigm was employed. Focused ethnographic methodology captured the cultural context of the ritual and its meaning. Purposive and snowball sampling were used to select the study participants. Indepth interviews with 13 circumcision mentors, participant observations in three churches, and narratives writing with 43 male students from six schools were conducted. Data were analysed using thematic analysis. The findings suggest a changing circumcision ritual with women at the forefront of most of these changes in a male arena ritual. The church, hospital, and urbanisation emerged as the drivers of change, through which women aimed at protecting their sons from practices in the ritual, that they deemed harmful, such as harassment and sexual violence. The changes in the male circumcision ritual are significant to public health.