Demographic statistics have shown the effects of the prevalence of HIV and AIDS in Zimbabwe. The Ministry of Health and Child Welfare (2008) established that out of 12 million people in Zimbabwe, 1.1 million were living with HIV and AIDS. Of the total population, 932 000 were people in the age group of 15–49. Although HIV and AIDS prevalence between 1981 and 1987 increased from 12 048 to 1 438 456, it declined in 2008 to 914 614 and a further decline to 911 143 was noted in 2009 (HIV and AIDS in Zimbabwe 2017). The decline in HIV and AIDS prevalence during this period was attributed to different strategies implemented by the government, such as campaigns on the use and distribution of condoms, reduction in casual sex, campaigns on abstinence as well as increased counselling and testing (HIV and AIDS, Zimbabwe 2013). However, whilst there was a general decline of HIV and AIDS prevalence in the ages 15–49, the prevalence rate in the age groups 15–29 continued to increase from 3.2% in 2009 to 3.3% in 2010 and 3.6% in 2015 (HIV and AIDS, Zimbabwe 2013). Some of the reasons suggested for the increase were high sexual risk behaviours and widespread unprotected sex.

‘Male circumcision has been identified in research as a protective cultural factor against HIV and AIDS’ (Bailey et al. 2007:644–650; Moses 2009:629). About 400 ethnic groups in West Africa and in Muslim countries have been practising the ritual of circumcision for over 500 years (Bongaarts et al. 1989; Weiss et al. 2000:64). Research has established ‘that circumcision might provide some degree of protection’ to HIV (Moses 2009:629-634).

The view that circumcision may protect human beings against HIV infection was introduced and developed by Professor Valiere Alcena in North America (Morris 1999:630).The theory was promoted by Fink (1986:1167) who argued that the removal of the penis foreskin and the subsequent hardening of the lining known as Keratinisation of the penis reduce the chances of HIV penetration. The underside of the foreskin consists of thin Langerhans cells which are vulnerable to the HIV virus (Ford 2006). Thus, circumcision makes the penis to develop a new, hardened skin with fewer HIV target cells.

According to Auvert (2005:298) and Rennie, Muula and Westreich (2007:357), ‘trials [carried out] in South Africa, Kenya and Uganda prove that male circumcision’ was effective in reducing infection. Welbourne and Hoare (2008) concur that these findings substantiate the fact that circumcision provides some protection against the HIV virus. Based on these findings, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) transformed ‘a cultural practice into a [preventive] public health strategy (Moses 2009:631)’. The suggestion was ‘that male circumcision [could] reduce’ heterosexual transmission of HIV and AIDS ‘by 60%’ (Van Houten 2007:168). Therefore, countries were urged to practise it in medical institutions through VMMC (WHO/UNAIDS 2015).

However, according to recent statistics on HIV and AIDS, Zimbabwe has the poorest coverage rate on circumcision ‘[d]espite […] being [listed as] [one of] UNAIDS’ priority [countries] for the scale up of [V]oluntary [M]edical [M]ale [C]ircumcision […] [that was] listed [on] the country’s National Combination Prevention Strategy’ (Avert n.d.; HIV and AIDS in Zimbabwe 2017). ‘By 2018, Zimbabwe aims to reach 1.3 million men [who would have undergone] VMMC (80% of [thirteen to twenty-nine-year] olds). As of 2016, it [has reached] 46.3% of [the] target group’ (Avert n.d.). It was surprising to note that HIV and AIDS prevalence is higher among men who are circumcised, 14% higher than those who are not (12%). Recent statistics show that Zimbabwe has the fifth highest HIV prevalence in sub-Saharan Africa, 14.7%. Approximately 1.4 million people are living with HIV and AIDS, including 77 000 children (HIV and AIDS in Zimbabwe 2017; Moyo 2017). The findings obtained from these studies suggest that circumcision on its own as an effective strategy is a conjecture. At individual level, circumcision does not prevent HIV transmission reliably (Mattson 2005:187). Men who tend to have surgical immunity after circumcision increase their risk of contracting the HIV virus.

The skewed statistics on HIV and AIDS in Zimbabwe shows that circumcision on its own is not enough as a prevention strategy against HIV. Hence, there is need for behaviour change after individuals have gone through voluntary male circumcision. Auvert (2005:79) opines that the risk of HIV transmission remains real among circumcised men who could increase their exposure by engaging in unprotected sex and risky behaviour. Circumcised persons may become promiscuous having learnt the benefits of circumcision in reducing the chances of contracting HIV and AIDS.

Another observation obtained from the statistics is that positive behaviour change after circumcision is crucial in militating against the spread of HIV and AIDS. Gray et al. (2007:558-659) observed that cultural circumcision and initiation have been useful in most African countries in preventing HIV and AIDS. This study hinges upon the view that religion and the strong adherence to religious principles could protect people against HIV and AIDS transmission (Agha et al. 2006:553). ‘Circumcision [on its own] cannot prevent the spread of HIV’ (Tarimo et al. 2012). After being circumcised, men need to go through initiation where they receive instruction necessary to mould their behaviours and assist them to develop positive and less risky attitudes towards issues of sex and sexuality.

Circumcision is a religious-cultural practice used in scientific circles to pursue the problem of HIV and AIDS in Zimbabwe. The adoption of traditional male circumcision for use by medical institutions left out the initiation aspect and all the ritual elements. The fact that the ritual has been performed from time immemorial means that it is of religious significance and is influential to those who practise it. Voluntary medical male circumcision is non-religious, non-obligatory and nothing compels the individual to undergo the ritual. ‘It has become increasingly important to focus research [on] the current role of initiation [rituals] and [their effects on] sexual behaviour and risk knowledge of the [youths]’ (Malisha, Maharaj & Rogan 2008).

Varemba or Vamwenye are the Shona speaking ethnic group indigenous to Zimbabwe and South Africa. According to Parfitt (2002:42-43), other Varemba minority groups are found in Mozambique and Malawi. Ethnic groups in Zimbabwe such as the Tonga, the Varemba, the Shangani and the Yao migrants perform initiation rites as puberty rituals of transition into adulthood (Sibanda 2013:5). Nevertheless, the religious beliefs and practices of the Varemba people are similar to those of the Jews and Muslims (Le Roux 2003:221). ‘According to [Varemba] tradition, their male ancestors were Jews who left Judea about 2500 years ago and settled in [Yemen]’ (Wikipedia n.d.:n.p). ‘Most [Varemba people] are members of the Christian churches with some being Muslims’ (Parfitt 2002:43; Wikipedia n.d.:n.p).

The Varemba are predominantly found in Mberengwa districts of the Midlands province and other parts of Masvingo, for example Gutu, Chiredzi, Neshuro, Hwedza and Buhera (Mandivenga 1989:98). The Varemba tribe has a long history of observing initiation of boys into manhood through practising traditional male circumcision among all their men folk. The Varemba circumcision and initiation rites are the footstool of enriching lessons that equip the young men to be conscious about their lives.

The origin of the circumcision rite is controversial, but to some extent, its origin is attached to issues of sex and sexuality. The Varemba people are believed to have acquired it from the Jews and Arabs to whom their ancestry and history is traced (Parfitt 2002:43). Circumcision is also interpreted to have ‘[originated] from […] fertility [rites] as a sacrifice to the gods in exchange for good harvest’ (Dunsmuir & Gordon 1999:7; WHO 2009:15). In the Bungoma Districts of Kenya, circumcision takes place after harvest (Bailey & Egesah 2006:650). ‘Among the [Balande] in Guinea-Bissau and Senegal circumcision ceremonies are […] performed in the rice fields [as] reverence to [the] ancestors and the [earth]’ (Niang & Boiro 2007:26; WHO 2009:15). Circumcision is also seen as a distinguishing feature between God’s children and those who are not (Popovsky 2010).

In Zimbabwe, the Shangani circumcise their youth at the ages between 13 and 17, whilst the Varemba circumcise from the age of 12 (Evans 2015; Sibanda 2013:3). The age group 15–29 is the most vulnerable group for new HIV and AIDS infection in Zimbabwe (HIV and AIDS, Zimbabwe 2013). The Varemba and the Bukusu in Kenya circumcise their youth every year, whilst in South Africa, it is performed twice, but the Balante in Guinea-Bissau circumcise after every 4–6 years (Bailey & Egesah 2006:33, Niang & Boiro 2007:30). In most cases, the circumcision rituals coincide with physical maturation and that makes it very useful in the growth of the young people. Bailey and Egesah (2006:649) established that about ‘47.7% of the young men’ in Kenya become sexually active before they are circumcised. Sexual debut was estimated to be at the average of 14–15 years in those groups studied for traditional circumcision (Bailey & Egesah 2006:567–574).

Most ritual elders pointed out that they are reluctant to take up voluntary medical circumcision because it does not meet their cultural expectations. Initiation transforms the individual into becoming man. Mombera Joseph (aged 17, participant from Matibi) acknowledged that individuals remain shuvuro after going through VMMC and they are good examples of cowards who run away from traditional circumcision in fear of pain. They would remain in the state of boys, who are looked down upon by their peers, who are laughed at and who are not trusted by anyone in society. Mombera claimed that such individuals are not equipped with adequate knowledge that is relevant to protect themselves from diseases.

Some participants indicated that the Varemba initiation ritual has prohibitions, which protects initiates from being vulnerable to sexually transmitted infections. It is a prerequisite that one who goes through the initiatory ritual should not mix or get into contact with women up to a period of 1 month after initiation. Jacob (participant, aged 15) noted that with hospital circumcision, meeting with women is not avoidable because women are involved in circumcision at medical centres.

The men from the Varemba culture who received voluntary circumcision pointed that behaviour change after circumcision is the individuals’ responsibility. No strategies are in place so far to enforce further restrictive avoidance strategies. Tendai Gonese (aged 19) acknowledges that VMMC is not imperative; it has no mechanisms to make it obligatory for members to change behaviours.

There are social cultural factors, which impede the uptake of VMMC. ‘Zimbabwe [is recorded to have] the poorest VMMC coverage […] in Sub- Saharan Africa’ besides being listed as ‘one of the [UNAIDS] priority countries for the scale up of [VMMC]’ (Avrt n.d:n.p.). According to statistics from HIV and AIDS in Zimbabwe (2017), Zimbabwe’s target for 2018 aimed at 1.3 million men to be circumcised, but by 2016, it had managed to achieve 46.3% of that target. Religious factors could have a contribution towards the low uptake of VMMC although other reasons like fear of pain and fear of being tested for HIV first. The Varemba people feel that their cultural traditions are under threat and they discourage their members from attaining medical circumcision.

Most people of the Varemba culture who participated in this research did not accept that they perform the ritual to prevent HIV and AIDS but the performances are purely cultural and religious. The discussion focuses on the role of the Varemba initiation ritual in the prevention of HIV and AIDS transmitted through heterosexual relations. The Varemba people do not have any primary intention of having the ritual influence the exterior world (outside them) or outside their own experiences that is the reason why their initiation ritual is closed to outsiders. According to Robertson Smith, some unconscious forces shape behaviour (Bell 2009). The implication is that it is not in all cases when believers are conscious of the main purpose of a ritual, the significance of a ritual could be different from what the believers believe.

In the analysis of taboo, Sigmund Freud notes that the ritual is used to control internal psychic conflicts (Spinelli 1989:34–38). The view that ritual exists in the individual psyche determines how ritual can influence individual behaviour towards HIV and AIDS mitigation processes, because behaviour change is intrinsically motivated. The Varemba initiation ritual is composed of both the manifest and latent functions, which should be realised to determine the efficacy of the ritual in HIV and AIDS prevention. Put in the context of HIV and AIDS the Varemba initiation ritual, besides having manifest functions, has latent functions which are buried underneath; such functions if exposed could be useful in the prevention of HIV and AIDS. In Freud’s view, the unconscious motive is the root for ritual but it guides the internal development of the individual, ritual thinking brings meaning to human beings in the face of emptiness and contradictions in their experiences (Spinelli 1989:35).

The Varemba circumcision and initiation ritual is very significant in imparting a sense of unity in the people after the ritual. This could be useful in bringing them together in the fight against HIV and AIDS. Moyo (participant, aged 21) points out that Makudo ndimamwe musi wenjodzi anoonerana, meaning that Baboons are the same, and on the day of trouble, they fight for each other. This has emphasis on unity of the people when reacting against issues causing despondency to the society. The implication is that the Varemba initiation ritual instils a sense of communal solidarity towards problems that affect the community. Collective solidarity is achieved in the initiation ritual through a mechanism which Durkheim calls collective effervescence (Durkheim 1912:52-53). This refers to the excitement that people produce during the enactment of a ritual. The effect of collective effervescence is that it contributes to the emergence of collective conscience that brings social solidarity as people participate in collective veneration of the sacred which binds the community together and brings meaning to individuals (Greenwald 1973:157-158). Therefore, collective performance can generate emotions that could transform individual psyches and channel them towards collective conscience (Pickering 1984). The collective excitement induced by rituals ‘harness[es] people’s passions to [maintain] order [in] society (Shilling & Mellor 1998:196)’ (Thorlindsson & Bernburg 2004). Through this solidarity the Varemba people have shared values, they develop a sense of ‘no one owns it, it’s for us all’, kind of mentality. In the context of HIV and AIDS, the kind of mentality is useful in helping those individuals who are affected and infected by the disease. Chandiwana (initiate aged 30) reinforced: Chawana umwe hachisekanwi, seka urema wafa, meaning one’s problem should not induce laughter because tomorrow you will be in a similar problem. The kind of unity instilled by the ritual act makes it possible for the people to come together and help each other in the struggle against HIV and AIDS.

The Varemba initiation ritual encourages youths to delay in sexual debut and this according to the Varemba initiation (Koyana 1980) is a gateway to legitimate marriage and sex. It is crucial to note that the initiation does not only involve circumcision, but has an accompanying process of instruction which has an educational feature ‘aimed at building certain character traits [like chastity, fortitude and] forbearance’ necessary for the prevention of HIV and AIDS (Vincent 2008b:436). In that ‘framework, sexual [behaviour] is shaped by personal experiences and influenced by cultural assumptions, expectations, roles and practices (Boyce et al. 2007:26)’ (Skinner et al. 2013). ‘[Culture determines] not only which sexual relations are acceptable, but also at what times and under what circumstances are they appropriate’ (Nkwi 2005:2135).

This study established that the Varemba initiates are taught how to make right choices at the appropriate time and are not encouraged to marry before they have gone through puberty rituals. Marriage is permissible when one has gone through initiation. In the Varemba culture, those recently initiated are not allowed to marry or engage in sexual relations up to a period of a year. Those who are married are not allowed to have sex up to 1 month. The practice could protect individuals from early exposure to sexually transmitted infections. This is contrary to other ethnic groups, for example the Nyau initiates of Zambia and Kikuyu of Kenya ‘are encouraged to have sex soon after the [initiation] ceremony’ to prove their learnt sexual prowess (Niang & Boiro 2007:25; Skinner et al. 2013).

Among the Varemba of Mwenezi, there is clear evidence that some participants changed their behaviour after going through initiation, to pursue safe sex habits. Gonzo (aged 58), from Rinnete village, confirmed that his son changed his attitude towards sex after initiation. The conditions outlined encouraged the initiates to delay marriage and sex. Those not yet gone through initiation would maintain primary virginity, which is virginity for one who has never engaged in sex before. The married people who attended the initiation ritual having had engaged in sexual relations were forced into secondary virginity. After initiation, they were forbidden to engage in sexual relations up to a period of a month. Such ideas could encourage the initiates to have delayed sexual debut that could be necessary in delaying risky chances of being exposed to contracting the HIV virus. Studies have shown that vulnerability to HIV and AIDS risk increases with early sexual debut (Ghebremichael, Larsen & Paintsil 2009:574; Hallett et al. 2007:5). An early onset of sexual activity, in or outside marriage put the individual at risk ‘by extending the period of potential exposure to sexually transmitted pathogens [and immaturity] of the reproductive organs further [enhances the chances of the] individual’s biological susceptibility’ (Ghebremichael et al. 2009:576). Culture helps to determine the sexual relations that are acceptable and not (Nkwi 2005:2135). Mhosva Regedzai (aged 82, from Nikita) confirms that the initiates are forbidden to have sex for several months after initiation. If they intend to have sex, they are encouraged to get married. Therefore, sex education obtained during the Varemba initiation rituals is a useful tool for effective HIV and AIDS prevention because it encourages late sexual debut.

Mturi and Hennink (2005)’s research on the initiation schools in South Africa concluded ‘that the schools do not educate participants about safe sex [and] the dangers of HIV and AIDS, and may encourage risky sexual behaviour’ (Malisha et al. 2008). These views only help to understand that the initiation schools’ curriculum about issues of HIV and AIDS is not manifest but latent. The Varemba initiation school does not discuss issues of HIV and AIDS explicitly and it is not their agenda to discuss such issues. Nevertheless, they provide lessons that are relevant towards change of behaviour in the youths whose benefit is lowering the risk of contracting HIV and AIDS and other sexually transmitted infections.

A study of ‘38 countries in Sub Saharan Africa [meant] to compare Muslims in the population against the confirmed rate of HIV prevalence, found [that] Muslims in national population correlates with lower HIV prevalence’ (Gray 2004:1753). Gray notes that most Muslims circumcise and they appear to engage in less risky sexual behaviours. The Varemba’s Islamic link has a bearing in understanding the effectiveness of strong adherence to some cultural practices in HIV and AIDS prevention. As in Islamic communities there is less risky behaviour, the perceived link helps to understand the Varemba initiation ritual as effective. ‘Male circumcision has been identified as protective cultural factor’ (Auvert et al. 2005; Moses 2009). Prevalence of HIV and AIDS in African societies which traditionally circumcise has been discovered to be low particularly West Africa and Muslim countries (Weiss et al. 2000:2366) ‘[D]ifferences in circumcision status [may help] to explain discrepancies in HIV prevalence’ (Halperin & Bailey 1990:1813-1814). It is not circumcision only which matters, but circumcision coupled with initiation that makes the Varemba people distinct.

The impact of the Varemba circumcision and initiation ritual on HIV and AIDS prevention can be observed on statistics about the prevalence of HIV and AIDS in Zimbabwe. Skewed statistics on HIV and AIDS in Zimbabwe show the need for behaviour change after individuals have gone through voluntary circumcision. It is of concern to notice that whilst the country is promoting circumcision as a measure to militate against the spread of HIV and AIDS, the prevalence rate in the circumcised population is increasing. Some of the reasons for the twisted statistics could be in line with what the research gathered in the field survey, which points to uninformed risky compensation behaviours. According to Doyle (2005), there is a need to work more directly on aspects of behaviour change in all ages and develop new cultural markers. Circumcised persons may become promiscuous having learnt the benefits of circumcision in reducing chances of getting HIV and AIDS.

The statistics could also mean that some groups of people do not accept medical circumcision which is why the coverage rate has been poor. Parirenyatwa, former minister of Health and Child Care in Zimbabwe, made a similar observation at the launch of VMMC in Marondera: ‘the uptake of male circumcision is still very low in the country although the service is offered for free at government institutions’ (Taruvinga 2015:18). Most of the Varemba participants in this research in Mwenezi show that they were against medical circumcision.

However, traditional surgical practices have been identified as potential sources of HIV infection especially when performed in a group of people (Feldman 1990:47). ‘[I]f […] serial use of [unsterilised] equipment features prominently’ it may well put the initiates at risk of HIV (Ajuwon et al. 1995:380). During the Varemba initiation ritual, the Nyamukanga uses one knife, which they rinse in cold water after using it on each initiate. According to Ajuwon et al. (1995:382), the process of using one knife during circumcision puts the initiates at the risk of contracting HIV. An unsterilised knife subsequently exposes initiates to the bodily fluids of the previous initiate (Hardy 1987:101). The ritual leaders may spread the HIV virus if they are infected and have open wounds (Feldman 1990:52). The findings of these researches should not necessarily ‘be construed as representative of [what transpires] in Sub-Saharan Africa’. Researchers have not established data that traditional surgical tools are vectors of transmission of HIV (Ajuwon et al. 1995:383-384). Packard and Epstein (1991:776) argue that a small number of initiates underwent incisions sequentially. In the case of Varemba initiation ritual, Chikwaya Mombe (aged 21, from Matibi) pointed out that not more than three initiates are circumcised at each interval, in the morning, afternoon and in the evening. There is significant time lapse between initiates that makes transmission through unsterilised object very unlikely because the virus does not survive long after it has been exposed (Ajuwon et al. 1995:382). Based on the responses of Gore Hukwe (aged 26, participant from Ndambi Village under chief Negare), during the Varemba initiation ritual there is considerable time lapse for treating the wound and washing the knife before the next initiate is circumcised. Gausset (2001) argues that most incisions are performed on adolescents who have lower prevalence of HIV and AIDS. Razor blades for use during shaving seemed affordable and accessible because each initiate could manage to bring one for use during the Varemba initiation ritual. According to Brightman (1995:520), the initiation practice has low potency towards transmission of HIV virus and therefore has an insignificant contribution towards the spread of HIV virus. Evidence gathered from the field shows that the Varemba ritual elders and the initiates are aware of the risks of spreading HIV and AIDS and each one of them is encouraged to bring his razor blade, for use in shaving the head and the pubic hairs.

The ordeals that the Varemba initiates go through have a positive contribution towards instilling positive and less risky behaviours in the youth. Asamoah (2001) laments the moral laxity of youth, and he thinks that the vulnerability of the youths to HIV and AIDS lies in their inability to control their sexual drive. Culture is responsible for socialising the youth and imparts them with requisites of humanness (unhu/ubuntu). Ntseane (2004:4) notes, ‘sex is culturally regulated, and accepted types of sexual behaviour are learnt through [socialisation]’. Through song and dance, the youth are furnished with sexual advice and instruction expected of them by the society. The Varemba initiation ritual offers a strategy and an opportunity of re-engagement and dialogue ‘with religious and ethnic groups in HIV [and AIDS] prevention’ (Pelzer et al. 2007:660).

Researchers have a tendency of focusing on biological strategies for HIV and AIDS prevention. According to Granich and Mermin (2001), most discussions on issues of HIV and AIDS focus on biological interventions as the primary key towards HIV transmission (Granich & Mermin, 2001). Nonetheless, such discussions circumvent the behavioural factors that have acted as impediments towards successful strategies. Granich and Mermin (2001) argue that biological technologies are at the top of the charts as treatment and prevention strategies, for example the use of highly active antiretroviral drugs and the use of condoms. All these require behaviour change. Kippax et al. (2011:394) note that AIDS is a social disease, its causes, consequences and human responses to it are deeply embedded in socio-cultural processes. The Varemba initiation ritual could be a valuable addition to the basket of strategies towards prevention of HIV and AIDS because it is culturally appropriate and locally relevant by targeting a specific group of people making them cognisant of their social context. The ritual strategy could have an idea over the type of behaviours to be changed for successful action.