Sexual pleasure or HIV prevention? A qualitative study of factors influencing male circumcision in Zambia

Male circumcision is often undertaken to reduce the spread of HIV/AIDS and other sexually transmitted infections. However, there has been a shift in the motivation to undergo the procedure, as many perceive it as improving their sexual performance. This study investigates factors that influence decision-making about male circumcision. This qualitative study used a combination of in-depth and focus group interviews with men and women to investigate factors that influence the decision to circumcise among Zambian men. In general, both men and women were aware of the protective benefits of male circumcision. Attitudes to medical male circumcision were favourable. However, women emphasised that circumcision should not be considered the only HIV prevention method. The interviews suggest that men perceive circumcision to improve their sexual performance. There was also a greater preference for circumcised partners among women due to the perception that intercourse with uncircumcised men is less pleasurable. These reasons may potentially overshadow the main reasons for which circumcision was initially advocated. The dangers of undergoing circumcision for sexual enhancement at the expense of reducing the risk of HIV and other STIs may have longstanding consequences and must be addressed.