HIV prevalence amongst men aged 15-49 in Botswana is 14.2%. In March 2010, the Government of Botswana began a campaign for Safe Male Circumcision (SMC) with hopes that it would turn the tide of the HIV epidemic. According to several studies, SMC can reduce the number of HIV infections by 60%. Uganda is one of the pioneers of this strategy and has already witnessed a decline in their HIV prevalence since the start of their SMC campaign.
PSI was approached by the Ministry of Health to lead the development and production of a national mass media campaign on SMC which was launched in April 2009, and received funding from the American Government through BOTUSA. The campaign uses the soccer analogy to describe the benefits of male circumcision in reducing the risk of HIV. In this advert, male circumcision is depicted as the goalkeeper among other defenders. The face of the campaign is the assistant national team goalkeeper Noah Maposa. Maposa’s participation has elicited a huge response from both males and females across all age groups in the country.
The Government of Botswana, through the Ministry of Health, is on a mission to scale up safe male circumcision service delivery by offering nation-wide services in 27 facilities. Their target is to circumcise 470,000 HIV negative men by 2016. To date approximately 10,000 men have been circumcised through this campaign, two such men are Tiro Morake and Moreetsi Goomang. Morake, a 22 year old male from Mahalapye, first heard about safe male circumcision through a national television advertisement. Shortly after, he came across an insert in a local newspaper In addition, Morake’s office displayed male circumcision brochures, which encouraged him to strike up conversations with his colleagues at the Madiba Theatre (one of PSI’s implementing partners). Through these discussions and exposure to different materials, he became aware of the benefits of the procedure. Morake comments, “It did not take me long to decide to do it, as I could clearly see how important the procedure is to my health and having people to talk to demystify most of the myths put me at ease. I went to Mahalapye hospital to book my procedure and got engaged in more discussions to get further clarification.” Morake went for his procedure on 22 November 2010, He then adds,” I now urge my peers who have not done it to consider doing it. I have realized that the hygiene issues I used to have before I did the procedure are no longer there.”
Moreetsi Goomang, a 26 year old male living in Tlokweng made the decision to get circumcised after visiting his local clinic where he was handed a safe male circumcision flyer. “I had gone there to see the doctor and a flyer was handed to several of us by a nurse and I made the decision to book for the procedure after the discussions we had. The discussion invoked a lot of excitement and interest among us as more benefits of the procedure were revealed to us” Goomang recalls. He had been exposed to safe male circumcision communications through billboards, radio adverts and even discussions at work but never took the final step because of the perceived physical pain associated with the procedure, “We would always wonder why we should get circumcised because we condomise consistently. We felt the pain we had to go through was not worth it as we knew how to effectively avoid the risk of HIV, “he remarks. According to Goomang, information in the safe male circumcision brochures focuses solely on benefits related to HIV. The discussion he had with the nurse revealed that there is more to male circumcision than just reducing the risk of contracting HIV. “I had encouragement from my friends who had already done the procedure and when you have people around you who have done it you are under pressure to do it as well for social standing,” he adds. Goomang realized, after doing the procedure on 15 August 2010, that as long as he had support from his family and friends, who looked after him during the recovery period, then to him the procedure was worth it.
Tshepho Otukile, Goomang’s friend, is a PSI Botswana employee who circumcised long before the campaign began, and took it upon himself to sensitize his friends about the benefits of safe male circumcision. It took him two months to convince Goomang to do the procedure, “I would always refer him to the adverts, pointing out that the benefits are not for HIV only but for other STIs as well. I made sure I talked about the overall health aspect.” Otukile found that talking to someone about safe male circumcision was somewhat complicated as it is a personal choice. He added that most of the time when discussing it with his friends, they mentioned that they were afraid of the complications during the procedure, as they tended to link it to traditional male circumcision. “I told them it is a perfectly safe procedure and out of the blue Moreetsi told me he was going to book. When he went for the procedure, I picked him up from home and waited for him until he was done and I took him back,” he recalls. Otukile wants to ensure that all his friends get circumcised. He only has four friends left to convince in order to reach his goal.
