‘Boys Will Be Boys’: Traditional Xhosa Male Circumcision, HIV and Sexual Socialisation in Contemporary South Africa.

Department of Political and International Studies, Rhodes University, Grahamstown, South Africa.
Culture Health & Sexuality (Impact Factor: 1.55). 07/2008; 10(5):431-46. DOI: 10.1080/13691050701861447
Source: PubMed

ABSTRACT Ritual male circumcision is among the most secretive and sacred of rites practiced by the Xhosa of South Africa. Recently, the alarming rate of death and injury among initiates has led to the spotlight of media attention and government regulation being focused on traditional circumcision. While many of the physical components of the ritual have been little altered by the centuries, its cultural and social meanings have not remained unchanged. This paper attempts to understand how some of these cultural and social meanings have shifted, particularly with respect to attitudes towards sex and the role that circumcision schools traditionally played in the sexual socialisation of Xhosa youth. Ritual circumcision is often defended on the basis of its usefulness as a mechanism for the maintenance of social order, particularly in relation to the perceived crisis in youth sexuality marked by extremely high levels of gender-based violence as well as HIV infection. However, the paper suggests two key ways in which traditional Xhosa circumcision has changed. These include the erosion of the role which circumcision schools once played in the sexual socialisation of young men and the emergence of the idea that initiation gives men the unlimited and unquestionable right to access to sex rather than marking the point at which sexual responsibility and restraint is introduced into the lifestyle of young men.

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    • "In this paper, we conduct a comparative textual analysis of two forms of sexual socialisation to which Grade 10 learners in two schools in the Eastern Cape are exposed: the Life Orientation (LO) manuals used by their teachers, and the songs voted most popular by the learners. We understand sexual socialisation as the multiple social processes through which norms, customs, understandings and practices surrounding sexuality are simultaneously enabled and constrained (Vincent, 2008). These social processes take on a number of forms, including formal teaching, social rites of passage, informal interactions, public health messaging, parental communication, personal experiences, and peer interactions. "
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    ABSTRACT: This paper compares two forms of sexual socialisation to which learners are exposed: the sexuality education components of the Life Orientation (LO) manuals and the lyrical content and videos of popular songs. We performed a textual analysis of the sexual subject positions made available in, first, the LO manuals used in Grade 10 classes and, second, the two songs voted most popular by the Grade 10 learners of two diverse schools in the Eastern Cape. Of interest in this paper is whether and how these two forms of sexual socialisation – one representing state-sanctioned sexual socialisation and the other learners' chosen cultural expression that represents informal sexual socialisation – dovetail or diverge. Against a backdrop of heterosexuality and an assumption of the 'adolescent-in-transition' discourse, the main sexual subject positions featured in the LO manuals are the responsible sexual subject and the sexual victim. A number of sexualised subject positions are portrayed in the songs, with these subject positions depicting sex as a site of pleasure, tension and complexity. Although these two modes of sexual socialisation use different genres of communication, we argue that learners' choice of songs that depict fluid sexual subject positions can help to inform LO sexuality education in ways that takes learners' preferred cultural expression seriously and that moves away from the imperative of responsibilisation. Available:
    Perspectives in Education 01/2015; 33(2):90-107.
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    • "The umkhwetha is transformed to be a responsible man. He is also taught about appropriate sexually behaviour, such as dangers of promiscuity and about marriage and starting of a family [10,13]. The whole ITMC procedure takes about four to eight weeks to complete and is usually performed during summer and winter seasons and coincides with school holidays (e.g., in June and December). "
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    ABSTRACT: Background Consistent use of condoms is the most effective method of preventing STIs including HIV. However, recent evidence suggests that limited knowledge about HIV prevention benefits from male circumcision leads to inconsistent condom use among traditionally circumcised men. The aim of this paper is to report on the prevalence of consistent condom use and identify its psychosocial correlates to inform future HIV prevention strategies among traditionally circumcised men in rural areas of the Eastern Cape Province of South Africa. Methods A cross-sectional study using interviewer administered fully structured questionnaires was conducted among 1656 men who had undergone initiation and traditional male circumcision in rural areas of the Eastern Cape Province of South Africa. Logistic regression was used to evaluate univariate and multivariate relationships of psychosocial correlates with consistent condom use. Results The mean age of the participants was 21.4 years. About 45% belonged to the amaXhosa ethnic group, followed by 15.1% of the amaMpondo, 11.6% of the amaHlubi, and 27.9% from other ethnic groups. A total of 72.3% reported having a main sexual partner and of those 44.8% indicated having other sexual partners as well. About 49% reported consistent condom use and 80% used free government issued condoms, varies among ethnic groups. A total of 35.1% indicated having tested for HIV. Of those who tested for HIV, 46% reported inconsistent condom use when having sex with their sexual partners. Univariate and multivariate analyses showed a positive association between consistent condom use and the general knowledge of condom use, attitude towards condom use with main and casual sexual partners, subjective norm towards condom use with the main sexual partner, perceived self-efficacy towards condom use, positive self-esteem, beliefs about traditional male circumcision and STI protection, attitude towards gender based violence, and cultural alienation. Conclusions The study findings reveal important target points for future cultural sensitive health education aimed at increasing consistent condom use among initiated and traditionally circumcised men in the Eastern Cape Province.
    BMC Public Health 06/2014; 14(1):668. DOI:10.1186/1471-2458-14-668 · 2.26 Impact Factor
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    • "Penile cutting practices have become of significant interest since large-scale clinical trials in Africa showed that male circumcision (MC) has a protective efficacy of around 60% in preventing HIV acquisition in heterosexual men (Auvert et al. 2005; Bailey et al. 2007; Gray et al. 2007; WHO/UNAIDS 2007; Siegfried et al. 2009). In some communities where MC for HIV prevention is being considered, evidence exists of a considerable variety of already established penile cutting practices within communities that have not been shown to be protective against HIV (Brown et al. 2001; Vincent 2008; Hill et al. 2012). That is, these penile cutting practices often do not involve full circumferential cut and removal of the foreskin but rather incisions that do not alter the size of the foreskin or minimize the exposure of langerhans cells that have been described as vulnerable to the HIV virus (McCoombe and Short 2006; Pask et al. 2008; Kigozi et al. 2009; Doyle et al. 2010). "
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    ABSTRACT: Background: Recent research as part of a multi-disciplinary investigation on the acceptability and impact of male circumcision for HIV prevention in Papua New Guinea (PNG) has shown that health workers (HWs) undertake unauthorized forms of penile cutting practices in public health facilities or in community settings, at times within a traditional context. Participation in these activities shares common features with coping mechanisms, strategies used by HWs to alleviate the burden of unsatisfactory living and working conditions. Coping mechanisms, however, are typically described as motivated by economic advantage, but in PNG evidence exists that the behaviours of HWs are also influenced by opportunities for social capital. Methods: Twenty-five in-depth interviews (IDIs) were completed with a variety of HWs from 2009 until 2011 and were triangulated with findings from 45 focus group discussions and 82 IDIs completed with community members as part of a wider qualitative study. Thematic analysis examined HW participation in unauthorized penile cutting services. Results: The emergence of unauthorized practices as a coping mechanism in PNG is compelled by mutual obligations and social capital arising from community recognition and satisfaction of moral, professional and cultural obligations. Using the example of unauthorized penile cutting practices amongst HWs in PNG, the research shows that although economic gains are not explicitly derived, evidence exists that they meet other community and socio cultural responsibilities forming a social currency within local traditional economies. Conclusions: Coping mechanisms create an opportunity to extend the boundaries of a health system at the discretion of the HW. Fragile health systems create opportunities for coping mechanisms to become institutionalized, pre-empting appropriate policy development or regulation in the introduction of new programmes. In order to ensure the success of new programmes, the existence of such practices and their potential implications must be addressed within programme design, and in implementation and regulation.
    Health Policy and Planning 10/2013; 29(7). DOI:10.1093/heapol/czt072 · 3.47 Impact Factor
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