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Now for some remarkable news out of Africa. Researchers announced this week that an unprecedented campaign to prevent HIV has convinced six million men and teenagers to get circumcised. The goal is to get another 14 million to sign up. And to do that, health officials are finding they need to change their message.

NPR's Nurith Aizenman has the story.

NURITH AIZENMAN, BYLINE: Turn on your radio in the capital of Zimbabwe these...


UNIDENTIFIED MAN #1: Time, weather and...


AIZENMAN: And it won't be long before you here this.


UNIDENTIFIED MAN #2: Hi, my name is Napster, The Radio Master. Just before I got married, I decided to get circumcised so that my wife would find me clean and desirable. I...


AIZENMAN: Here's what DJ Napster doesn't say: his ad is really about curbing HIV. It's a centerpiece of a national campaign. Getting circumcised reduces a man's chances of contracting HIV by 60 percent. That's because removing the foreskin creates a less hospitable environment for the virus. This drive to circumcise men in Africa started a couple of years ago, across 14 countries.

And at first, just telling men the true reason behind the campaign was enough. But public health officials know that if they can get 80 percent of the men in these countries circumcised, they'll prevent 3.4 million new infections. They also know that for a lot of men, the down sides of going under the knife just don't seem worth it.

DINO RECH: It's not an easy sell, you know? It's probably one of the greatest marketing challenge of all times.

AIZENMAN: That's Dr. Dino Rech. He's been leading the effort to circumcise men in South Africa, where one in six adults have HIV.

RECH: What you're essentially asking is for a healthy young gentleman to come in for a procedure which is associated with a level of pain which asks the gentleman to abstain from sex for at least a six week period. Certainly a massive ask.

AIZENMAN: And those are only two of the reasons men are leery. Webster Mahvu is a researcher working on Zimbabwe's campaign.

WEBSTER MAHVU: I'm a social scientist by profession.

AIZENMAN: He's been trying to figure out how to motivate more men to get circumcised. Some told him they were nervous about the HIV test. Everyone has to take one before the operation. Others told him their wife objected. Why would they worry about HIV unless they were planning to cheat. Then there were the rumors, the circumcision drive was a government plot to sterilize men. It has happened.

MAHVU: Another was that the foreskins were being used for Satanism. You know, there's so much fear of Satanism.

AIZENMAN: Satanism, witchcraft. Sometimes when people get sick, they think it's because an enemy has cast a spell on them. But Mahvu's research also pointed to a way forward. He asked those who did volunteer why they signed up. And while a lot of them talked about HIV, they also gave reasons that had nothing to do with the disease: Being circumcised is more hygienic, they said. Women find you more attractive and you can last longer during sex.

Mahvu said he found that last argument so intriguing it helped convince him to get circumcised.

MAHVU: To be honest, I noticed a difference after getting circumcised, my secular life kind of improved and I loved it.

AIZENMAN: That's essentially the message Zimbabwe's government is now focusing on and it's working. Men are showing up in droves, about 20,000 a month. All of which raises a question: Is this campaign somehow misleading?

KARIN HATZOLD: It's not lying to people. We have to promote getting circumcised.

AIZENMAN: That's Dr. Karin Hatzold. She helped design Zimbabwe's marketing campaign. She points out that HIV rates there have fallen significantly over the past decade. So while it's still a problem, HIV may not be the most pressing concern on people's minds. She says you have to talk to people about what they're most worried about, not what you think they should worry about. Nurith Aizenman, NPR News.

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