Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia


Von Daniel O. Ashipala, Trymore B. Nhokwara, Medusalem H. Joel


Die Freunde und Profiteure der Massenverstümmelung wühlen fleißig weiter

Sub-theme 1: Myths and misconceptions: According to the
participants, the biggest barrier to VMMC is mistaken beliefs
or wrong ideas about the procedure. Some men believe that
if they get circumcised, some misfortune will befall them or
their sexual life will change for the worse:




‘Some clients revealed that they cannot get circumcised because
they believe that after circumcision the sexual pleasure will be
diminished’




‘One client told me that he does not want to get circumcised
because if the foreskin is removed the penis will develop some
cracks’

Mythen? Kann alles passieren und passiert. Reduzierter sexueller Genuss, Narbenbildung, Meatusstenosen... aber das darf man den Zielpersonen doch nicht erzählen - denn es geht ja um "to motivate males to voluntary medical male circumcision uptake" und um Provisionen, Vorhaut-Fangprämien.

Sub-theme 2: Age limitations: One participant (a surgeon)
raised a concern that a limitation is set as there is a minimum

age at which a male can be circumcised. The surgeon added
that they are only allowed to circumcise males from 15 years
old and they are now getting fewer clients than before:
‘Due to the new developments, we can only circumcise males
from 15 years of age and because of that we are now getting
fewer clients’. (P5, 31 years old, Surgeon)

fewer clients == weniger Knete. Verdammt!

These findings are supported by
those that were obtained in a study conducted in Zimbabwe
on early infant male circumcision by Mavhu et al.,32 which
indicated that most people do not agree with the idea of
circumcising infants as they believe only those who are old
enough to take care of themselves should be circumcised.

Nee, also so was! Schon wieder ein Mythos!

This is in contrast to some reports of the progress in male
circumcision has been reported where eight countries
experienced an increase in the proportion of clients in the
< 15 years age ranges from 2016 to 2017. This shift was largest
in Rwanda (5% – 28%), Botswana (45% – 66%) and Namibia
(12% – 34%), all relatively small programmes Davis et al.33

Die ganze Zeit immer "VMMC"...
Was haben Zwangsamputationen an Kinder mit "voluntary" zu tun?
PEPFAR hat die Finanzierung von BGM unter 15 Jahren nicht freiwillig eingestellt, sondern weil die Zahl der schweren Komplikationen einfach zu hoch war!

Recommendations to increase the uptake of
voluntary medical male circumcision

...more education to clear up myths
and misconception

Aha. Wobei die Möglichkeit von negativem Einfluss auf die Sexualität ja schon als "myth" abgetan wurde.

....circumcision for boys at a young age...

Und dann von "freiwillig" schwafeln! Die sind für eine Zirkumzision ebenso einwilligungsfähig wie in Sex mit Erwachsenen. Gar nicht.

Competing interests
The authors declare that they have no financial or personal
relationships that may have inappropriately influenced them
in writing this article

Nee, ist klar...

researchgate.net/profile/Danie…-Kavango-East-Namibia.pdf