'At risk by fact of birth': perceptions and concerns about medical male circumcision for HIV prevention in northern Malawi
In this article, we draw on critical approaches to risk to examine varied and interlaced perceptions of personal risk for HIV which young men in an area of traditionally low male circumcision have to Malawi government's new policy of medical male circumcision for HIV prevention, locally known as mdulidwe. In this article, we draw on data from in-depth interviews (n = 29) and focus groups (n = 24) with young men aged 18-24 years undertaken in 2013 in an area with traditionally low rates of circumcision, Livingstonia in the northern region district of Malawi. Our findings show that the push for medical male circumcision in this region has given rise to a perception that the penile foreskin is an inborn anomaly that leads to excessive risk for HIV provoking anxiety, confusion, uncertainty, fatalistic views, and waning faith in national response to the epidemic. Our analysis of the data indicates that medical male circumcision has ushered in a layered and sometimes conflicting understanding of risk for HIV/AIDS where established ideas grounded in sexual propriety and risk-taking are being re-evaluated and reinterpreted within an emerging worldview coloured with sensibilities pertaining to notions of bodily normalcy. This indicates that the men in our study had a nuanced understanding of risk for HIV that incorporated notions of sexual risk-taking with corporeal impropriety, necessitating appropriate public risk communication about HIV/AIDS and policy responses for its prevention.
|Keywords||HIV/AIDS, Malawi, male circumcision, policy, risk, risk perception|
|Journal||Health, Risk and Society|
Mkandawire, P, Dixon, J. (Jenna), Luginaah, I. (Isaac), Armah, F. (Frederick), & Arku, G. (Godwin). (2014). 'At risk by fact of birth': perceptions and concerns about medical male circumcision for HIV prevention in northern Malawi. Health, Risk and Society, 16(4), 295–307. doi:10.1080/13698575.2014.919994