LAUSR

AimMalawi officially launched Voluntary Male Medical Circumcision (VMMC) in 2012 after the 2007 joint WHO /UNAIDSrecommendation that VMMC be a key HIV prevention strategy for Sub-Sahara African region. Malawi data, however, contradicted thefindings of three randomized studies conducted in Uganda, Kenya and South Africa between 2005 and 2007. While randomized trialsdemonstrated that male circumcision could contribute to a 60% relative reduction of HIV acquisition by men through heterosexualintercourse, HIV prevalence in Malawi was highest in the Southern Region where 47% of males were traditionally circumcised yetCentral Region had 15.4% and Northern Region, 6.3%. By December 2018, Malawi had only achieved 756, 780 surgeries constituting31% against the target of 60% of eligible men. The low achievement was due to resistance to services even in traditionally circumcisingYao communities. This study sought views of Yao respondents in Mangochi district, in Southern Malawi, on VMMC.Methods156 participants were interviewed (103 males and 53 females): 15 FGDs (involving 86 males and 50 females); 17 IDIs (involving 14males, 3 females); 3 Key KIIs (involving 3 males, 0 females). For this paper, the authors only analyzed FGDs, IDIs and KIIs. Quotesfrom FGDs were not significant.ResultsThe study identified that VMMC: a) did not contribute to societal moral values; b) involved female circumcisers; c) threatenedchiefs’ political authority and economic gains; d) threatened continuity of jando; e) was impotent against witchcraft; f) provided byinefficient providers; g) resembled Yao circumcision; h) wrongly translated as ‘m’dulidwe wa abambo.’ConclusionsThe key barrier to VMMC services in Yao communities of Mangochi was the mistrust between government and implementers on onehand and Yao communities on the other due to inadequate engagement prior to the rollout of services.