Health Transition Review, Supplement to Volume 7, 1997, 337-359.

Aspects of male circumcision in sub-equatorial African culture history*

Jeff Marck

Health Transition Centre, National Centre for Epidemiology and Population Health, Australian National University

The distribution of circumcision and iniation rites throughout Africa, and the frequent resemblance between details of ceremonial procedure in areas thousands of miles apart, indicate that the circumcision ritual has an old tradition behind it and in its present form is the result of a long process of development.

Wagner (1949:335)


This paper describes the general cultural background of male circumcision for the Bantu speaking peoples of sub-equatorial Africa. Where the contemporary cultural context of male circumcision is now variable and often transformed among groups who continue the practice, traditional practices were commonly of a particular and rather narrow profile linked to the toughening, training and initiation of male adolescents into warrior status. For those groups the normal social context of circumcision was in the adolescent rites of passage typically called 'initiation schools' in the ethnographic literature. These in turn were highly associated with 'age-grades', age ranked male cohorts whose membership was defined by participation in the same initiation schools in the same year. Linguistic evidence suggests the schools and circumcision are very ancient and typological arguments suggest that these Bantu groups which do not circumcise males have abandoned a once more widespread practice. In the main, the Bantu groups which do not circumcise males belong to certain contiguous linguistic groups and their neighbours from amongst bordering Bantu subgroups. Almost all groups which have abandoned male circumcision have also abandoned initiation schools and age-grades. This constitutes a culture area in terms of those dimensions of those societies. Circumcising and non-circumcising groups are suggested to have their distribution due to diffusion of loss and it cannot be expected that differential risk behaviours in relation to HIV infection will be found to sort similarly among Bantu-speaking or other African peoples. But such mapping, for those who would do it, can now take place with the knowledge that a cluster of cultural traits typify the non-circumcising Bantu groups.

*This paper was developed at the Department of Anthropology, University of Copenhagen and finalized at the Health Transition Centre, National Center for Epidemiology and Population Health, Australian National University.

[CIRP Note: This lengthy and significant article has five maps, and a longish text. In the interest of getting some of these findings on line as rapidly as possible, CIRP presents only selected portions of the text. Additional portions will be added as time permits.]


The African AIDS epidemic is a predominantly heterosexual epidemic with a subordinate epidemic involving mother to child transmission. Transmission through intravenous drug use, male homosexual activities and other means significant on other continents are rarely observed in the African epidemic. Mundane penile-vaginal sex acts are the main mode of transmission accross the continent. The primary demonstrated cause for elevated rates of HIV transmission through sexual contact is the presence of genital ulcer diseases and this seems to be the general background as to why parts of Africa have a raging heterosexual epidemic and why other parts of the continent and, for instance, poor people in wealthier nations do not1 or have seen such develop more slowly. Lack of male circumcision has been mentioned as a possible factor in elevated rate of female-to-male transmission in published case-control studies from Africa since about 1986 or 1987 and in prospective studies of individuals since 1988 (Cameron et al. 1988, 1989). Cameron et al. (1988, 1989) inspired two ecological studies (Bongaarts et al. 1989; Moses et al. 1990) which showed a striking positive relationship between those parts of Africa which have high rates of HIV-1 and those that have low rates of male circumcision. I shall not comment here on the resulting literature but refer the reader to some recent articles2 concerning the 'chancroid/circumcision' model of the epidemic. Here, over ten years after lack of male circumcision began to be mentioned as a possible factor in the epidemic, I wish to start talking about what male circumcision means to Africans in the Bantu-speaking portions of the 'AIDS Belt' of sub-equatorial Africa, and to consider why it has its historical distribution amongst Bantu speakers.

Organization and results

The geographical distribution of African groups traditionally practising male circumcision is reviewed. It is noted that the central and southern portions of a region where it was not practised in the AIDS belt is dominated by groups speaking 'Bantu' languages. Recent archeological and linguistic theories as to how Bantu languages came to have historical distribution are mentioned. Terms for 'male circumcision' and 'male initiation school' amongst Bantu languages are discussed in light of what evidence they might offer for the general antiquity of male circumcision amongst Bantu-speaking groups. A typological argument is presented suggesting that either male circumcision was a practice of societies speaking Proto-Bantu or that the practice came to be general amongst Bantu speakers quite anciently but after the disintegration3 of Proto-Bantu or that the practice came to be general amongst Bantu speakers is explained as due to subsequent loss through a continuous area whose edges are defined by the edges of a series of Bantu language subgroups. It is noted that sub-equatorial groups, regardless of language family, tend to do what their neighbours do in respect to circumcision.

[CIRP Note: A large amount of text, maps, and other data are omitted here]


Here we have asked how male circumcision has come to have its particular distribution among Bantu-speaking peoples. The result has been the suggestion that male circumcision was an ancient practice amongst the Bantu and that non-circumcising Bantu groups have abandoned the practice. The abandonment of initiation schools and age grades is implied by this model. These observations may come to be of significance in isolating other cultural variables that distinguish some of the non-circumcising Bantu groups, or groups of such groups.

While this may be of interest in AIDS intervention strategies, I hold little hope that it will result in the identification of different risk behaviours between circumcising and non-circumcising groups. Lack of male circumcision among Bantu speakers is a real phonomenon: at the time of the earliest relevant European description, the non circumcising Bantu groups had abandoned the practice through a contiguous area. In an ultimate sense they had abandoned it because their neighbours had, and differences in sexual risk behavior for HIV transmission cannot be expected to sort according to those same boundaries. Still, there may be some hope of isolating significant differences when it is observed that the core whih have also abandoned male adolescent rites of initiation and, except in the south, age-grades. But these are a kind of 'package' of interrelated institutions and cannot presently be shown to have anything to do with differences in heterosexual risk behaviour.

The only material seen in the present work to suggest different risk behaviour between circumcised and uncircumcised persons was for individuals within the same group and concerned men leaving their traditional lands for wage labour in cities or at mines before they were of an age to be circumcised, including men who specifically left for such employment to avoid circumcision. Then, commonly, the uncircumcised men had wages to avail themselves of prostitutes while those who remained in traditional lands were circumcised and availed themselves of prostitutes less frequently or not at all.

In general, male circumcision amongst Bantu speakers defined a change in status at the time of earliest European description. This involved a clear break between a childlike status, elevation to warrior status (except in Group E) and generally toughening or hardening of boys to men. The model proposed here suggests that the tendency through Bantu-speaking areas in prehistory was for more and more groups to abandon this practice. Presumably this is accelerating, especially amongst the fringes of the non-circumcising areas, as male circumcision is now sometimes simply emblematic or traditional, although still signifying adult status, and commonly lacks the wider social significance it once had.

1. That is, because a difference in frequency and kinds of sexually transmitted diseases, especially genital ulcer diseases.

2. Caldwell (1995) and Caldwell (1993, 1994, 1996), Conant (1995), Mertens and Carael (1995), Moses et al. (1995), and Ntozi (1995) refer to the general behavioural literature and some of the biomedical literature. Plummer et al. (1991) makes chilling reading at this time as it provides the cultural background of Cameron et al. (1988, 1989) and a model for the central core of the next many millions of infections through the AIDS Belt.

3. The divergence of 'daughter' languages through geographical spread, passage of time and the isolation or localization of speech.


Bongaarts, J. P. Reining P. Way and F. Conant. 1989. The relationship between male circumcision and HIV infection in African populations. AIDS 3;373-377.
Caldwell, J.C. 1995. Lack of male circumcision and AIDS in sub-Saharan Africa: resolving the conflict. Health Transition Review 5,1:113-117.
Caldwell, J.C. and P. Caldwell. 1993. The nature and limits of the sub-Saharan African AIDS epidemic; evidence from geographical and other patterns. Population and Development Review 19;4:817-848.
Caldwell, J.C. and P. Caldwell. 1994. The neglect of an epidemiological explanation for the distribution of HIZ/AIDS in Sub-Saharan Africa: exploring the male circumcision hypothesis. Health Transition Review 4 (Supplement):23-46.
Caldwell, J.C. and P. Caldwell. 1996. The African AIDS epidemic. Scientific American 274,3:40-46.
Cameron, D.W., J.N. Simonsen, L.J. D'Costa, et al. 1988. Female to male transmission of Human Immunodeficiency Virus type 1: risk factors for seroconversion in men. American Society for Clinical Investigation, Washington, May 1988 and the 4th International Conference on AIDS, Stockholm, June 1988.
Cameron, D.W., J.N. Simonsen, L.J. D'Acosta, et al. 1989. Female to male transmission of Human Immunodeficiency Virus type 1: risk factors for seroconversion in men. Lancet 2:403-407.
Conant, F. 1995. Regional HIV prevalence and ritual circumcision in Africa. Health Transition Review 5,1:108-113.
Moses, S., J. Bradley, N. Nagelkerke, A. Roland, J. Ndinya-Achola and F. Plummer. 1990. Geographical patterns of male circumcision practices in Africa: association with HIV seroprevalence. International Journal of Epidemiology 19,3:693-697.
Wagner, G. 1949. The Bantu of North Kavirondo. London: International African Institute.

(File revised 4 December 2006)

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