Njombe, Tanzania—Selemani Nyika, a 60-year-old farmer and patriarch of a large Njombe family, is among those few men who are circumcised through traditional methods in a region where male circumcision is not a norm. Some of his sons also have been circumcised.
Nyika, however, became concerned about the safety of the instruments used and the high price demanded by traditional circumcisers. When he heard radio ads announcing safe and free male circumcision services at a government health facility, Nyika recognized a safe and affordable opportunity that would benefit his family’s health. “When I heard that male circumcision is not only free, but also protective against HIV, I thought this was the opportunity I have been waiting for, for my sons who are not yet circumcised,” said Nyika.
In June of this year, voluntary medical male circumcision (VMMC) was being provided as part of a comprehensive HIV prevention package of services at the Uhenga Dispensary in Nyika’s home village. The father wasted no time in taking 11 of his sons—ages 10 through 21—to the health facility, where they were all circumcised on the same day.
With funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID), the Government of Tanzania is scaling up HIV prevention services, including VMMC. This initiative is bringing these services close to families in Njombe and the neighboring Iringa region, two areas that have the highest prevalence of HIV in Tanzania and a low proportion of men who are circumcised. This innovative program is implemented by the Ministry of Health and Social Welfare, Regional Health Management Teams, and the Maternal and Child Health Integrated Program (MCHIP), which is led by Jhpiego.
Nyika’s sons were among 33,000 men who received this important HIV prevention service during a two-month campaign held in the two regions. Clients are counseled about and tested for HIV and educated about the benefits of VMMC, which reduces HIV acquisition in heterosexual men by 60 percent.Clients learn that male circumcision provides substantial, although partial, protection against acquiring HIV. They also learn that to protect themselves further, they should delay sexual activity or reduce their number of sexual partners, use condoms, and know the HIV status of their partners through couples counseling and testing.
With more than 250,000 men and boys circumcised in Njombe and Iringa since 2010, the MCHIP-supported VMMC program has now become a movement that is changing social norms. As a result of this program, circumcised men now outnumber uncircumcised men in Njombe and Iringa.
“Thanks to this program, all my sons are now circumcised, and protected too,” said Nyika, who has 38 children with his five wives.
Two days after the procedure, Nyika’s eldest wife, Salima Pendaeli, escorted their 11 sons to the dispensary for follow-up care. “Male circumcision does not only involve men. As the most senior wife and mother, I took the responsibility to escort our children to the clinic today,” she said. “I have also been motivating other women in the village to encourage their husbands and bring their sons for circumcision.”