Traditional Male Circumcision in Malawi and HIV Prevention

马拉维的传统男性包皮环切术与艾滋病毒预防

• 批准号: 7647458
• 负责人: Judith A Levy
• 金额: $ 27.31万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7647458
• 关键词: AIDS education/prevention; AIDS prevention; AIDS/HIV problem; Accounting; Acetylcysteine; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adopted; Adult; Affect; Africa; Age; Area; Behavior; Belief; Bereavement; Brothers; Burial; Camping; Cause of Death; Cessation of life; Child; Childhood; Communities; Complement; Country; Custom; Data; Demographic and Health Surveys; Diffusion of Innovation; Disease; Educational process of instructing; Elderly; Epidemic; Equipment and supply inventories; Ethnography; Event; Family; Fathers; Focus Groups; Future; Gender; Gender Relations; Geographic Locations; HIV; HIV diagnosis; Health; Heterosexuals; Husband; Hygiene; Infection; Interview; Knowledge; Learning; Life; Life Cycle Stages; Malawi; Male Adolescents; Male Circumcision; Maps; Marriage; Methods; Nature; Operative Surgical Procedures; Participant; Phase; Polygamy; Population; Preparation; Prevalence; Prevention; Prevention program; Procedures; Professional counselor; Property; Prostitution; Puberty; Recruitment Activity; Religion; Research; Research Personnel; Rights; Risk; Ritual compulsion; Role; Sampling; Schools; Self Perception; Sex Behavior; Sexual Partners; Spouses; Staging; Time; Traditional Medicine; Training; Tribal group; United States National Institutes of Health; Vertical Disease Transmission; Virus; Widow; Wife; Witchcraft; Woman; Youth; boys; caregiving; cohort; cultural values; design; expectation; experience; fight against; male; man; meetings; men; prevent; programs; prospective; sex; sexual debut; sexual relationship; theories; transmission process; young adult

DESCRIPTION (provided by applicant): This 3-year qualitative study is designed to examine and understand the cultural norms, beliefs and practices surrounding traditional male circumcision rites (Jando) as the context and mechanism through which definitions of manhood, health and illness, and the sexual mores, customs, and gender expectations for sexual partnering are transmitted from elders to youth among the Yao tribal group of Malawi. In a country with an adult prevalence rate that is the 8th highest in the world, Yaos account for about 18% of the country's cases of AIDS. The study focuses on youth undergoing male circumcision rites because these ceremonies form the single most important socio-cultural mechanism for socializing Yao boys into the culture's sexual values and gender relationships. The period of sequestering that precedes and follows circumcision is also the only time according to tradition when matters of a sexual nature including HIV/AIDS are allowed to be openly discussed. Data will be collected in 3 Phases using a multi-method approach that includes in-depth interviewing, focus groups, environmental mapping, a surgical inventory, and ethnographic observations of 5 villages. The sample will consist of: initiates (ages 7-9), 3 cohorts of post-initiates (ages 10-13; 14-17; 19- 20), the ceremony's circumciser, the 2-3 traditional counselors who administer the Jando schooling and oversee the circumcision camp, and the male attendant/supporters (Phungo) for each initiate. The proposed study will use a Life Course Perspective to explore and understand how traditional socio-cultural norms and practices of male circumcision as a status passage at puberty among the Yao intersect with the dynamics of the Malawi AIDS epidemic. In addition, Diffusion of Innovation Theory will be used in examining how information relevant to sexual behavior, gender relationships, and HIV/AIDS is transmitted through these ceremonies as well as the rite's potential for future AIDS prevention programming. The study also is timely in the wake of new evidence showing the efficacy of male circumcision in helping to prevent male heterosexual HIV transmission, and the WHO call for research that can guide the safe and culturally appropriate use of the procedure. Because the Yao male circumcision rites are part of a widespread Bantu tradition practiced throughout southern and other parts of Africa, besides benefiting Malawi in its fight against AIDS, results of the study also are potentially generalizable to other parts of Africa.

描述（由申请人提供）：这项为期 3 年的定性研究旨在检查和理解围绕传统男性割礼仪式 (Jando) 的文化规范、信仰和实践，作为男子气概、健康和疾病定义的背景和机制，以及在马拉维的瑶族部落中，性道德、习俗和性别对性伴侣的期望是从长辈传给年轻人的。在这个成人患病率居世界第八位的国家，瑶族人约占该国艾滋病病例的18%。这项研究的重点是接受男性包皮环切仪式的年轻人，因为这些仪式构成了使瑶族男孩融入该文化的性价值观和性别关系的最重要的社会文化机制。根据传统，割礼前后的隔离期也是唯一允许公开讨论包括艾滋病毒/艾滋病在内的性问题的时间。将采用多种方法分三个阶段收集数据，包括深入访谈、焦点小组、环境测绘、手术清单以及对 5 个村庄的民族志观察。样本将包括：入会者（7-9 岁）、3 组入会后者（10-13 岁、14-17 岁、19-20 岁）、仪式的割礼师、负责 Jando 学校教育的 2-3 名传统辅导员并监督割礼营地，以及每个入会者的男性服务员/支持者（Phungo）。拟议的研究将采用生命历程的视角来探索和理解男性包皮环切术作为瑶族青春期地位通道的传统社会文化规范和做法如何与马拉维艾滋病流行的动态相交叉。此外，创新传播理论将用于研究与性行为、性别关系和艾滋病毒/艾滋病相关的信息如何通过这些仪式传播，以及该仪式在未来艾滋病预防规划中的潜力。这项研究也是及时的，因为有新的证据表明男性包皮环切术有助于预防男性异性恋艾滋病毒传播，世界卫生组织呼吁开展研究来指导安全且在文化上适当的使用该程序。由于瑶族男性割礼仪式是非洲南部和其他地区普遍实行的班图传统的一部分，除了有利于马拉维抗击艾滋病之外，这项研究的结果也可能推广到非洲其他地区。