Dynamics of male circumcision practices in northwest Tanzania.

BACKGROUND: Male circumcision status is considered an important cofactor in the spread of HIV and sexually transmitted disease. There is limited evidence that male circumcision practices in Africa may be changing. GOAL: To assess the determinants of male circumcision status in a traditionally noncircumcising ethnic group and to investigate the reasons for increasing acceptance of circumcision.
METHODS: Data from a factory workers study and a rural cohort study in northwest Tanzania were used to analyze the levels and determinants of male circumcision status and assess the reliability of self-reported data. Qualitative data from focus group discussions and in-depth interviews were obtained to ascertain norms and values in relation to male circumcision.
RESULTS: Male circumcision has become more popular in recent years, and 21% of 3,491 men reported themselves as circumcised. An increase in circumcision rates was observed in the rural cohort study during 1994 to 1997, though reporting inconsistencies are common. Circumcision rates were higher among men with higher levels of education and in Muslim men. Men are often circumcised in their late teens or twenties. The reasons for the increasing popularity of circumcision were investigated in group discussions and in-depth interviews. The most frequently mentioned reason was health-related; circumcision was thought to enhance penile hygiene, reduce sexually transmitted disease incidence, and improve sexually transmitted disease cure rates.
CONCLUSION: Male circumcision is becoming more popular among a traditionally noncircumcising ethnic group in Tanzania, especially in urban areas and among boys who have attended secondary schools.