205949 Female genital cutting prevalence and instrument sanitation among the Maasai of Tanzania

Sunday, November 8, 2009

Aaron J. Siegler, MHS , Rollins School of Public Health, Emory University, Atlanta, GA
Jessie Mbwambo, MD , Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
Ralph J. DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Background: Female genital cutting (FGC) has been practiced on 10% of Tanzanian women, despite the illegality of its practice for girls under 18. The Maasai of Northern Tanzania have traditionally practiced FGC. In addition to humans rights violations, blade sharing may present a route for HIV transmission.

Methods: A cross-sectional, randomized survey of Maasai adults (n=370) in two rural areas in Northeast Tanzania produced the study data. Interviewers were gender-matched to respondents. Survey items were developed based on preliminary qualitative assessments. The survey had a high response rate (91%) and analyses adjust for survey design.

Results: The overall prevalence of FGC among Maasai women is 84%. Among the Ilarussa section prevalence is lower (50%) while the practice is nearly universal among all other sections (96%). Women are cut in groups of 2.1, and 26% used a shared instrument owned by the practitioner. The shared instrument is usually cleaned between uses with water or milk (94%). Most other women bring their own knives (71%), which have not previously been used for FGC. Personal knives used for the procedure may be the same as those used to slaughter livestock and prepare food.

Conclusions: FGC is still highly practiced where tradition dictates. Some women face risk of HIV transmission from shared blades, although this risk is attenuated through blade cleaning. Women may face excess non-STD infection risk due to unsterile blades. Projects addressing FGC should consider adding to their FGC elimination efforts a harm reduction strategy of providing sterile instruments to traditional practitioners.

Learning Objectives:
1. Describe risks of infection from female genital cutting; 2. Identify five challenges of addressing female genital cutting among rural populations.

Keywords: Female Genital Mutilation, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my MHS in International Public Health at Johns Hopkins University in 2005. This work is the topic of my dissertation at Emory University, funded by a NIH National Research Service Award. Research findings stem from 9 months of fieldwork in Tanzania, working with local collaborators at Muhimbili University. I am responsible for the research design, implementation and analysis presented in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.