Research studies have revealed that male circumcision (MC) reduces the transmission
of HIV infection from infected women to circumcised men by up to 60% (UNAIDS
2007:2), hence the adoption of MC as an HIV-infection prevention strategy by the
United Nations (WHO 2007:2). Botswana, a sub-Saharan African (SSA) country, has
HIV as a leading health and developmental challenge. The government adopted male
circumcision as one of the strategies to combat the infection. Apparently, not all tribes in
Botswana practise male circumcision as part of their culture. The purpose of this study
was to develop and describe a model for HIV-infection prevention using MC. Three
theory-generating research objectives were used to develop the model, namely to
explore and describe perceptions of men regarding the use of MC, to develop and
describe a model for MC service delivery, and to develop and describe guidelines for
service providers to facilitate delivery of MC. A theory-generating research design which
is qualitative, exploratory, descriptive, and contextual was used to develop the model in
three phases.
Phase 1 involved concept identification, concept definition, and concept classification.
Data was collected using focus group discussions and individual in-depth interviews
among 38 men aged 18-49 years and analysed according to recommendations made
by Tesch (1990), as cited in Creswell (2009:186). Four themes emerged in the study,
namely perceived effects on values, perceived source and provision of information,
perceived knowledge of benefits of male circumcision, and perceived risks of male
circumcision. The concept of “culture congruence” was derived from the themes as
the main concept for the development of a “culture-congruent MC model for HIV
prevention”.
Phase 2 involved a description of the structure and the process of the model, by
organising the concepts in relation to one another. The model was also evaluated.
Phase 3 of the model involved the development of guidelines to support health service
providers to provide MC services in a culture-congruent way in preventing HIV infection.
Recommendations made were incorporation of transcultural health care instruction in
nursing and medicine curricula, research on secondary audiences, such as women, and
application of a culture-congruent MC model among diverse cultures.