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Introduction
Male circumcision remains one of the oldest and most widespread surgical procedures worldwide. The major reasons why it is undertaken vary from religious, cultural, social to medical (WHO & UNAIDS, 2007). However, Bonner (2001) and Doyle (2005) asserted that male circumcision practice is not universally standard and, therefore, many forms of circumcision procedures are practised around the world. In some cases, the whole foreskin is removed, while in other instances a small part of the foreskin is cut. According to Jewish law, even boys who are born with a naturally circumcised penis must be circumcised through a drop of blood drawn ritually from an already circumcised penis (Hoffman, 1996). Nevertheless, according to Rain-Taljaard et al. (2003), male circumcision is the removal of the foreskin or prepuce, either surgically or non-surgically, which covers the head (glands) of the flaccid penis. The current medical form of circumcision entails the complete surgical removal of the foreskin of the penis by a health professional. In recent years, the main reason for undertaking male circumcision in sub-Saharan Africa has been to reduce or minimize the risk of sexually transmitted infections (STIs), including HIV, from infected women to men (Wabwire-Mangen et al., 2009).
Most countries in southern Africa that are currently embracing Medical Male Circumcision (MMC) are mainly driven by the objective of HIV prevention, especially amongst previously non-circumcising ethnic groups. Medical Male Circumcision was endorsed by WHO/UNAIDS in 2007 as an HIV-combating strategy, hence generating a lot of interest. The major motivation for MMC being adopted as a new health intervention came from three randomized controlled trials conducted in South Africa, Kenya and Uganda (Auvert et al., 2005; Bailey et al., 2007; Gray et al., 2007). These showed that circumcision substantially reduces the chances of transmission of HIV through heterosexual intercourse by approximately 60%. An uncircumcised penis contains Langerhans cells with HIV receptors that can be the primary entry point for the HIV virus (Szabo & Short, 2000). Removing the Langerhans cells leaves the glands penis thinly keratinized, thus reducing HIV infection. Other studies have shown that male circumcision reduces the incidence of other STIs such as syphilis and gonorrhoea (Gray et al.,...