The recent promotion of male circumcision as a public health strategy in settings with low circumcision rates is based on research evidence suggesting that male circumcision provides heterosexual men with 50 to 60 per cent protective benefit against HIV infection. For the Kikuyu people in Kenya, male circumcision is a cultural ritual and a rite of passage from childhood to adulthood. The study explored the male circumcision ritual and practices in Muranga, Kenya and their implications on public health. A qualitative research design underpinned by an Interpretivist paradigm was employed. Focused ethnographic methodology was used to capture the cultural context of the ritual and its meanings. Participants were recruited through purposive sampling method. Data were collected through in-depth interviews with 13 circumcision mentors, participant observations in three churches and written narratives with 43 male students from six schools. Data were analysed using thematic analysis. The findings suggest a changing circumcision ritual with women as key agents of change in a ritual considered a male arena. The church, hospital and urbanisation emerged as the drivers of the changes which women effected with the aim of protecting their sons from institutional bullying and the culture of pain in the era of HIV and AIDS. The latest change in the ritual feature boys getting circumcised and recuperating in hospitals. The changes in male circumcision practices are of significance to public health. The changes in sexual practices are likely to increase the risk of HIV infection counteracting the protective effect expected of circumcision. The study recommends a revision of policies especially the WHO policy on male circumcision for the effective impact on HIV prevention among the circumcising communities. Women can be engaged in mobilising changes in the circumcision ritual that are significant to the health of young men through institutions such as hospitals and churches.
|Publication status||Accepted/In press - 1 Dec 2014|