The Feasibility of Performing Male Circumcision at Two Clinics South African Public

Abstract

Study objective: To assess the feasibility of performing male circumcision at the primary care clinic level.

Design: A prospective study of all patients circumcised during a 5-month period (April to September 1997) at two primary care clinics. The design included a short questionnaire administered before the procedure by the first author to assess the demographic characteristics reason(s) for circumcision and expectations of the patients about the procedure.

Setting: The study was conducted in two peri-urban primary health care clinics namely Hebron and Bethesda located in the Odi health district of the North West Province.

Results: Seventy-five (75) male circumcisions were performed during the 5-month period. The response rate for the questionnaire was 100% and the majority of the participants were adolescents (84%). Almost all the adolescents reported that their friends considered and referred to them as "small boys" because they were not circumcised and that was the main reason for the procedure. All the participants expected circumcision to be painful, but the majority (89,3%) expressed the need to receive anesthesia for the procedure. The healing time of the circumcision wounds was within ten days for the vast majority of the participana (71/75), and pain at the operation site was the most common complication following the procedure - 29,3% (22/75).No wound infection was reported or seen during the study.

Conclusion: This study demonstrates the feasibility of performing safe male circumcision at the primary health care level at a reasonable cost to the community when compared with the private health sector. The emotional and psychological component of the initiation into manhood (peer pressure) has an important role in sexual health of young black African men and this needs to be explored adequately, if this procedure is to be widely practiced in the public health system. By so doing, an important window of opportunity for sexual health promotion will be available.