Open Access Highly Accessed Research article

"Now we are in a different time; various bad diseases have come." understanding men's acceptability of male circumcision for HIV prevention in a moderate prevalence setting

Angela Kelly12, Martha Kupul1, Lisa Fitzgerald3, Herick Aeno1, James Neo1, Richard Naketrumb1, Peter Siba1, John M Kaldor4, Andrew Vallely14* and of the Male Circumcision Acceptability and Impact Study (MCAIS) team

Author Affiliations

1 Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, PO Box 60, Goroka EHP 441, Papua New Guinea

2 International HIV Research Group, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia

3 School of Population Health, University of Queensland, Brisbane, Australia

4 Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research), University of New South Wales, Sydney, Australia

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BMC Public Health 2012, 12:67  doi:10.1186/1471-2458-12-67

Published: 22 January 2012



Adult male surgical circumcision (MC) has been shown to reduce HIV acquisition in men and is recommended by the WHO for inclusion in comprehensive national HIV prevention programs in high prevalence settings. Only limited research to date has been conducted in countries experiencing moderate burden epidemics, where the acceptability, operational feasibility and potential epidemiological impact of MC remain unclear.


A multi-method qualitative research study was conducted at four sites in Papua New Guinea (PNG), with 24 focus group discussions and 65 in-depth interviews carried out among 276 men.


The majority of men were in favour of MC being introduced for HIV prevention in PNG and considered improved genital hygiene, enhanced sexual pleasure and culturally appropriateness key factors in the acceptability of a future intervention. A minority of men were against the introduction of MC, primarily due to concerns regarding sexual risk compensation and that the intervention went against prevailing cultural and religious beliefs.


This is one of the first community-based MC acceptability studies conducted in a moderate prevalence setting outside of Africa. Research findings from this study suggest that a future MC program for HIV prevention would be widely accepted by men in PNG.

Acceptability; Male circumcision; Papua New Guinea; HIV prevention