Literature review and rationale Ritual circumcision has been practised for centuries in Africa and other parts of the world. Clinical trials have shown that adult male circumcision, if performed correctly, could play a role in the prevention of HIV transmission and protect against invasive penile cancer. The prevalence of ritual circumcision practiced in Eastern and Southern Africa varies from about 80% in Kenya to about 20% in Uganda and Southern Africa. The procedure referred to as ritual circumcision is performed in a non-clinical environment by a traditional circumcisionist with no formal medical training. The main geographical area for this rite of passage in South Africa is among the Xhosa-speaking people of the Eastern Cape.