Background: For years, male circumcision (MC) has been known to reduce the risk of sexually transmitted
infections (STIs). Of late, MC has been recognised and recommended as a complementary HIV preventive
measure in high prevalent areas. The objective of this study was to assess the perceptions of Swazi men
about the protective effect of circumcision against STIs including HIV, and its implication to the mass MC
strategy.
Methods: An explorative qualitative study was conducted targeting men aged ≥18 years seeking services at
Family Life Association of Swaziland clinic in Mbabane, Swaziland. Unstructured individual face-to-face
interviews were conducted for 17 men.
Results: Results showed that Swazi men perceived the protective effect of MC differently, ranging from
perceptions of ineffectiveness and unworthy, especially against HIV, to perceptions of total protection and
a solution to all STIs. Perceptions were influenced by the ongoing circumcision campaigns, individual
knowledge of biological sciences, misconceptions as well as life experiences. Promiscuous men were more
likely to have a positive perception and acceptance of the procedure than their non-promiscuous
counterparts.
Conclusion: Swazi men hold mixed perceptions about MC, accounting for its relatively low uptake. The
relatively low uptake of circumcision does not necessarily imply failure of the strategy but rather a natural
selection of the most relevant and at-risk portion of the population. It is recommended that more effort be
put towards correcting misconceptions and convincing those who still hold a negative perception about
the procedure.