IntroductionMenopause denotes the end of a woman’s reproductive life. A woman’s experiences of menopause are shaped by her individual circumstances and may vary between social and cultural contexts. Evidence is needed to inform research... more
IntroductionMenopause denotes the end of a woman’s reproductive life. A woman’s experiences of menopause are shaped by her individual circumstances and may vary between social and cultural contexts. Evidence is needed to inform research and programme delivery that supports women’s health and well-being throughout the menopausal transition. This scoping review will map evidence of women’s experiences of menopause in Asia Pacific countries, where limited research exists.Methods and analysisWe will follow the five-stage framework of Arksey and O’Malley, further developed by Levac et al and the Joanna Briggs Institute. MEDLINE, CINAHL, PsycINFO and Scopus databases will be systematically searched between February 2022 and May 2022 using subject headings and keywords. The title–abstract and full text of retrieved studies will be assessed against eligibility criteria. The review will focus on studies with a qualitative research component. Citation searching of selected articles will suppl...
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The use of contraceptives for family planning improves women’s lives and may prevent maternal deaths. However, many women in low and middle-income countries, including the Pacific region, still die from pregnancy-related complications.... more
The use of contraceptives for family planning improves women’s lives and may prevent maternal deaths. However, many women in low and middle-income countries, including the Pacific region, still die from pregnancy-related complications. While most health centres offer family planning services with some basic contraceptive methods, many people do not access these services. More than 60% of women who would like to avoid or delay their pregnancies are unable to do so. This scoping review identifies and analyses evidence about family planning service provision in Pacific Island Countries and Territories (PICTs), with the aim of better informing family planning services for improved maternal health outcomes in the Pacific. We used Arksey and O’Malley’s scoping review guidelines, supported by Levac, Colquhoun and O’Brien to identify gaps in family planning service provision. Selected studies included peer-reviewed publications and grey literature that provided information about family plan...
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Background Globally, experiences of menarche and subsequent menstruation are embedded in social and cultural beliefs, norms and practices. Menarche is an important developmental milestone in sexual and reproductive health (SRH) for... more
Background Globally, experiences of menarche and subsequent menstruation are embedded in social and cultural beliefs, norms and practices. Menarche is an important developmental milestone in sexual and reproductive health (SRH) for females. Menarche is intertwined with socio-cultural norms, beliefs and practices, which can impact on women’s ability to manage menstruation with dignity. This paper reviews the social and cultural factors that affect women’s ability to effectively manage their menstrual health and hygiene (MHH) in Pacific Island Countries and Territories (PICTs). Methods A scoping review was conducted following PRISMA scoping review guidelines and inclusion/exclusion criteria. An online search was conducted for peer-reviewed publications in Medline/OVID; Medline/PubMED; PsycINFO; CINAHL; Scopus and JSTOR, and Google Scholar. A search for grey literature was conducted in Google Scholar and websites of international and local organizations. Experts in the field also contr...
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As life expectancy increases for Indigenous populations, so does the number of older adults with complex, chronic health conditions and age-related geriatric syndromes. Many of these conditions are associated with modifiable lifestyle... more
As life expectancy increases for Indigenous populations, so does the number of older adults with complex, chronic health conditions and age-related geriatric syndromes. Many of these conditions are associated with modifiable lifestyle factors that, if addressed, may improve the health and wellbeing of Indigenous peoples as they age. If models of healthy aging are to be promoted within health services, a clearer understanding of what aging well means for Indigenous peoples is needed. Indigenous peoples hold a holistic worldview of health and aging that likely differs from Western models. The aims of this review were to: investigate the literature that exists and where the gaps are, on aging well for Indigenous peoples; assess the quality of the existing literature on Indigenous aging; identify the domains of aging well for Indigenous peoples; and identify the enablers and barriers to aging well for Indigenous peoples. A systematic search of online databases, book chapters, gray liter...
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As doctoral students, we were well aware of the social, cultural, and economic isolation experienced by many students working towards a PhD. In this paper, we provide an account of an informal peer support model that assisted us to... more
As doctoral students, we were well aware of the social, cultural, and economic isolation experienced by many students working towards a PhD. In this paper, we provide an account of an informal peer support model that assisted us to successfully complete our PhDs. We used co/autoethnography to write into each other’s story, seeking to improve our research practice through creative reflection. Data included over 215 emails generated through our “weekly check-ins” during our PhDs, for a period of over 18 months. Following the iterative nature of co/autoethnography, we generated further data through collaborative analysis and reflexive, creative writing. Analysis involved each of us conducting inductive analysis of the data separately, followed by a collaborative process of checking and co-identifying themes, and collaborative writing of the co/autoethnography. We identified three major themes in the data: Being an Academic, Doing Academia, and Sharing in Academia. We continue to transf...
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Background Menarche, the first menstruation, is a significant developmental milestone for females. In Papua New Guinea (PNG), menarche is an important socio-cultural event marking transition from girlhood to womanhood. PNG is a culturally... more
Background Menarche, the first menstruation, is a significant developmental milestone for females. In Papua New Guinea (PNG), menarche is an important socio-cultural event marking transition from girlhood to womanhood. PNG is a culturally and linguistically diverse nation, with wide-ranging socio-cultural beliefs and practices around menarche. This study explored post-menarcheal women’s understanding about body changes and menarche, preparation for menarche, and related cultural beliefs and practices at menarche. Methods A constructivist grounded theory study was conducted with 98 female participants who originated from four PNG provinces: Eastern Highlands Province; East Sepik Province; Milne Bay Province; and National Capital District. The participants were purposively and theoretically sampled, with 10 focus group discussions and six individual interviews conducted using a semi-structured interview guide for data collection. Focus group discussions and interviews were voice recor...
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Background: The use of family planning contraceptives helps improve women’s lives and prevent maternal deaths. Globally, maternal mortality has been significantly reduced between 1990 and 2015. However, the gains have not been evenly... more
Background: The use of family planning contraceptives helps improve women’s lives and prevent maternal deaths. Globally, maternal mortality has been significantly reduced between 1990 and 2015. However, the gains have not been evenly spread with the majority of deaths still occurring in low- and middle-income countries. Solomon Islands, a low-income nation in the Pacific, faces the continued challenge of low contraceptive use and unmet needs for family planning. There is also still a gap between knowledge about contraceptives and their actual use. This study explores the barriers and enablers to family planning, including contraceptive use at Atoifi Hospital, Solomon Islands and presents strategies that may increase contraceptive use. Methods: In this qualitative study, semi-structured face-to-face interviews were facilitated with family planning nurses, contraceptive users and non-users to explore the barriers and enablers for women and men accessing family planning, including cont...
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Until recently, researchers have been reticent to use secondary data to generate grounded theory. Secondary data (also known as retrospective data) is data collected by other researchers and used in a separate research project to... more
Until recently, researchers have been reticent to use secondary data to generate grounded theory. Secondary data (also known as retrospective data) is data collected by other researchers and used in a separate research project to understand the phenomena under question. This presentation outlines the use of a secondary data set to inform the development of a grounded theory. Collected by researchers in a multi-site study in Papua New Guinea (PNG), the data set (qualitative and quantitative data) was theoretically sampled to explore the implications for women of male circumcision for HIV prevention. Researchers used chunks of data from the secondary data set to stimulate discussion in new focus groups and to generate new knowledge about the phenomena. The weaving of understandings from secondary and primary data has informed a grounded theory to inform HIV prevention policy and health promotion strategies in PNG.
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Background In Papua New Guinea (PNG) members of key populations, including female sex workers (FSW), men who have sex with men (MSM) and transgender women (TGW), have higher rates of HIV compared to the general adult population and low... more
Background In Papua New Guinea (PNG) members of key populations, including female sex workers (FSW), men who have sex with men (MSM) and transgender women (TGW), have higher rates of HIV compared to the general adult population and low engagement in HIV care. This paper examines the socio-ecological factors that encourage or hinder HIV treatment initiation and adherence among HIV positive members of key populations in PNG. Methods As part of a larger biobehavioural survey of key populations in PNG, 111 semi-structured interviews were conducted with FSW, MSM and TGW, of whom 28 identified as living with HIV. Interviews from 28 HIV positive participants are used in this analysis of the influences that enabled or inhibited HIV treatment initiation and treatment adherence. Results Enablers included awareness of the biomedical benefits of treatment; experiences of the social, familial and health benefits of early treatment initiation and adherence; support provided by family and friends;...
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Water, sanitation and hygiene (WASH) systems in schools contribute to successful education by promoting good health and supporting school attendance. Girl students and students with disability face significant challenges when there are... more
Water, sanitation and hygiene (WASH) systems in schools contribute to successful education by promoting good health and supporting school attendance. Girl students and students with disability face significant challenges when there are inadequate WASH systems. Pacific Island Countries and Territories (PICTs) have some of the lowest levels of improved WASH systems on earth. The aim of this review was to document the characteristics and effectiveness of approaches to improve WASH systems that promote the health and education of girl students, and students with disability in PICTs. This systematic scoping review comprehensively searched peer-reviewed and grey literature about WASH, PICTs, schoolgirls and students with disability. At best, there are only fleeting mentions in the grey literature about WASH and disability in schools in PICTs. Inclusion and exclusion criteria resulted in 12 publications being included: 1 review; 7 original research; 4 commentaries/project reports. A holist...
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In meeting the social and emotional learning (SEL) needs of Aboriginal and Torres Strait Islander students, the capacities of school staff are critical. There is very limited evidence for relevant capacity development initiatives. This... more
In meeting the social and emotional learning (SEL) needs of Aboriginal and Torres Strait Islander students, the capacities of school staff are critical. There is very limited evidence for relevant capacity development initiatives. This evaluation reports a multicomponent SEL training intervention delivered to staff of an Australian education service that operates independently of any particular school to assist with the transitions of students from remote communities to boarding schools. A participatory action research (PAR) approach was implemented over 13-months with 21 staff participants. Results from a pre-, mid- and six months post-training survey and staff interviews were analysed and fed back through reflective group discussions. The training was associated with improved staff attitudes to mental health and skills to support student wellbeing. Sixteen participants received a tertiary qualification. Despite ‘working in challenging environments’, staff were ‘dedicated to help’ ...
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More than 4000 Indigenous Australian students enrol and take up a placement at boarding school each year. While reasons for attending boarding school vary, the impetus for many remote and very remote-dwelling students is restricted... more
More than 4000 Indigenous Australian students enrol and take up a placement at boarding school each year. While reasons for attending boarding school vary, the impetus for many remote and very remote-dwelling students is restricted secondary educational opportunities in their home communities. A large multi-site study is being undertaken across Queensland to understand the conditions required for these students to be resilient while studying away from home. This paper reports on levels of student satisfaction with Queensland Department of Education's Transition Support Service (TSS) that provide assistance to remote-dwelling Indigenous students in the transition to boarding schools. A survey instrument administered to students included 22 close-ended questions to elicit levels of student satisfaction with TSS. Data were collected electronically using SurveyMonkey™ and analysed in SPSS v24. Descriptive statistics were calculated for variables assessing service support, student pe...
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In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been... more
In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators-all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous...
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Grounded theory has been evolving methodologically since Barney Glaser and Anselm Strauss first described it in the late 1960s. Initially underpinned by modernist philosophy, grounded theory has had recent turns including the adoption of... more
Grounded theory has been evolving methodologically since Barney Glaser and Anselm Strauss first described it in the late 1960s. Initially underpinned by modernist philosophy, grounded theory has had recent turns including the adoption of both constructivism and postmodernism. This article explores ontological offerings of critical realism as a basis for transformational grounded theory informed by participatory action research and decolonizing research methodologies. The potential for both theory and action to result from this critical grounded theory methodology, which promotes greater participation and equity of power for positive change, is the transformational in transformational grounded theory.
Research Interests: Sociology, Nursing, Epistemology, Social Work, Participatory Action Research, and 11 moreQualitative Methods, Grounded Theory (Research Methodology), Transformational Leadership, Grounded Theory, Constructivist Grounded Theory, Decolonizing Methodologies, Critical methods, Cross Cultural, Theory development, Particpatory Action Research, and Decolononizing Research Methodologies
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Objective: We report the background to and preliminary evaluation of the Leadership in Mental Health: Island Nations course, run for the first time in Cairns in conjunction with Creating Futures 2015. Conclusion: The course was well... more
Objective: We report the background to and preliminary evaluation of the Leadership in Mental Health: Island Nations course, run for the first time in Cairns in conjunction with Creating Futures 2015. Conclusion: The course was well attended and well received, with increased confidence in key areas demonstrated and concerns regarding local application identified. In addition to positive comments, content and delivery issues were raised. Future opportunities for expanding upon this initial course are discussed.
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This paper describes a capacity building process undertaken within the HIV/AIDS prevention project of the Adventist Development and Relief Agency (ADRA) in the Solomon Islands. ADRA HIV/AIDS has recently reoriented its project structure,... more
This paper describes a capacity building process undertaken within the HIV/AIDS prevention project of the Adventist Development and Relief Agency (ADRA) in the Solomon Islands. ADRA HIV/AIDS has recently reoriented its project structure, moving beyond its awareness raising approach to incorporate health promotion frameworks, theories, strategies and assumptions. These have been used to inform project practice in project planning, delivery and evaluation. This paper shares what has worked and not worked in the capacity building process, including a project evaluation of the initial HIV/AIDS awareness raising project and the application of a number of capacity building strategies, including utilising a volunteer Australian Youth Ambassador for Development (AYAD) funded by the Australian Agency for International Development (AusAID). Existing and new projects are outlined. The underlying theme is that any capacity building exercise must include structural support (e.g. management, nati...
Research Interests: Management, Marketing, Engineering, Education, Health Promotion, and 15 moreHealth Education, Developing Countries, Capacity Building, Medicine, Prevention, HIV, Melanesia, Capacity Development, Humans, Pacific, Organizations, AIDS, Behaviour change, Acquired immunodeficiency syndrome, and HIV infections
In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this... more
In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumc...
Research Interests: Africa, Male Circumcision, General Internal Medicine, Public Health, Health Services Research, and 15 moreHealth Policy, Papua New Guinea, Medicine, Policy making, Humans, Pubmed, Male, HIV Prevention, Incidence, Adult, New Guinea, Preventive Health Services, Medical and Health Sciences, HIV infections, and Population surveillance
Research Interests: Nursing, Mental Health, Curriculum, Community Health Workers, Pacific Islands, and 13 moreHumans, Queensland, Female, Male, Psychiatric Nursing, Nursing Education and Research in Nursing, Middle Aged, Adult, Clinical Competence, Guidance and Counseling Intervention Programs, Pilot Projects, Educational program, and Inservice training
Research Interests: Sociology, Operations Research, Grounded Theory, Public Health, Health Services Research, and 11 moreCapacity Building, Medicine, Research Agenda, Literature Review, Focus Group, Health Professionals, Research Needs, Public health systems and services research, Intervention study, Focus Group Discussion, and Literature Search
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Papua New Guinea is the largest land mass and population in Melanesia. The population experiences myriad health and social challenges including: poverty, violence, maternal mortality, intimate partner violence, malaria, TB, and Sexually... more
Papua New Guinea is the largest land mass and population in Melanesia. The population experiences myriad health and social challenges including: poverty, violence, maternal mortality, intimate partner violence, malaria, TB, and Sexually Transmitted Infections including HIV. Against a background of government directed closure of social marketing for condoms, constitutional religious sensibilities, a health department official calling for 'adultery to be made a criminal act', and a purported position that it is culturally difficult to discuss the intimate, we highlight evidence that when people are provided a safe and confidential context they do openly talk about sexual health concerns. We outline how, during data collection for the 'Acceptability of Male Circumcision for HIV Prevention in PNG' study (data presented elsewhere), male participants were asked for a clinical examination and photo of their penis in order to verify circumcision status reported in the study questionnaire. Men were also given the opportunity to speak with a sexual health clinician with or without the clinical examination. We describe the high acceptance rate of clinical examination and photography of men volunteering for the study, and outline the various sexual health concerns that men presented with. Implications for health service delivery and sexual health research are discussed including: the unmet need for sexual health services, the enthusiastic acceptance to engage in clinical examination and the willingness to talk openly about sexual health concerns
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Summary Social workers are an integral part of end-of-life (EOL) care interdisciplinary services and provide comprehensive psychosocial support to dying people. However, despite the rewards, EOL care social work is wrought with... more
Summary Social workers are an integral part of end-of-life (EOL) care interdisciplinary services and provide comprehensive psychosocial support to dying people. However, despite the rewards, EOL care social work is wrought with challenges. There is currently limited research into the experience of EOL care social workers. Therefore, this qualitative interpretive meta-synthesis (QIMS) study examines the experience of EOL care social workers as revealed in existing literature. The QIMS methodology was used to synthesize and interpret findings from four original qualitative studies to elicit an in-depth response to the research question: What is the experience of social workers who work in EOL care? Findings The theme “EOL care social work is a privilege and a struggle” emerged, with six associated contributing factors: Privilege—(1) death is sacrosanct, (2) death is an opportunity for growth and healing, and (3) the religious/spiritual element of EOL care. Struggle—(1) ongoing pain an...
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Western research and education draw heavily on evidence-based approaches underpinned by positivism. Reliance on this scientific approach informs what is to be counted, measured, and tested—what can be “known.” In our experience, evidence... more
Western research and education draw heavily on evidence-based approaches underpinned by positivism. Reliance on this scientific approach informs what is to be counted, measured, and tested—what can be “known.” In our experience, evidence generated using this approach does not always bring the most useful outcomes in our diverse, naturalistic settings. In fact, often the proffered solution can distance and dehumanize the very people expected to be beneficiaries. In this article, we, as researchers and educators from different cultural and professional backgrounds in the “post-colonial” South Pacific, pose an alternative to this Western approach. We engage in a story saturated process akin to collaborative auto-ethnography. We first undertake a process of owning our stories, critically reflecting upon ourselves and how we approach evidence. In the context of values-driven, dialogical relationships, we experiment with intersectionality, interdisciplinarity, and experiences of time and ...
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Papua New Guinea is the largest land mass and population in Melanesia. The population experiences myriad health and social challenges including: poverty, violence, maternal mortality, intimate partner violence, malaria, TB, and Sexually... more
Papua New Guinea is the largest land mass and population in Melanesia. The population experiences myriad health and social challenges including: poverty, violence, maternal mortality, intimate partner violence, malaria, TB, and Sexually Transmitted Infections including HIV. Against a background of government directed closure of social marketing for condoms, constitutional religious sensibilities, a health department official calling for 'adultery to be made a criminal act', and a purported position that it is culturally difficult to discuss the intimate, we highlight evidence that when people are provided a safe and confidential context they do openly talk about sexual health concerns. We outline how, during data collection for the 'Acceptability of Male Circumcision for HIV Prevention in PNG' study (data presented elsewhere), male participants were asked for a clinical examination and photo of their penis in order to verify circumcision status reported in the study ...
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With words as data, qualitative researchers rely upon language to understand the meaning participants make of the phenomena under study. Cross-language research requires communication about and between linguistic systems, with language a... more
With words as data, qualitative researchers rely upon language to understand the meaning participants make of the phenomena under study. Cross-language research requires communication about and between linguistic systems, with language a site of power. This article describes the use of the lingua franca of Tok Pisin in a study conducted to explore the implications of male circumcision for human immunodeficiency virus (HIV) prevention for women in Papua New Guinea. Utilizing a transformational grounded theory methodology, researchers conducted an analysis of data from an HIV prevention study. Researchers then facilitated individual interviews and interpretive focus groups to explore preliminary categories identified during the analysis. Most focus groups and interviews were conducted in the local lingua franca Tok Pisin, which is neither the researchers’ nor most participants’ first language. Audio recordings were transcribed and analyzed. Researchers returned to research participant...
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IntroductionCommunity-based Participatory Women’s Groups (PWGs) have proven to be an effective intervention to improve maternal and child health (MCH) outcomes in low/middle-income countries (LMICs). Less is known about how PWGs exert... more
IntroductionCommunity-based Participatory Women’s Groups (PWGs) have proven to be an effective intervention to improve maternal and child health (MCH) outcomes in low/middle-income countries (LMICs). Less is known about how PWGs exert their effects in LMICs and virtually nothing is known about the contextual issues, processes and power relationships that affect PWG outcomes in high resource settings. The aim of this systematic review is to synthesise and critically analyse the current evidence on how and why PWGs improve the quality of MCH care. We aim to demonstrate how PWGs function and why PWG interventions contribute to social and health outcomes.Methods and analysisThe protocol will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. The databases Medline (Ovid): Cumulative Index to Nursing and Allied Health Literature (Ebsco); Informit health suite Scopus, Australian HealthInfoNet, the Cochrane Library and other sources will be searc...
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Male circumcision reduces the risk of female-to-male transmission of human immunodeficiency virus (HIV) and is being explored for HIV prevention in Papua New Guinea (PNG). PNG has a concentrated HIV epidemic which is largely... more
Male circumcision reduces the risk of female-to-male transmission of human immunodeficiency virus (HIV) and is being explored for HIV prevention in Papua New Guinea (PNG). PNG has a concentrated HIV epidemic which is largely heterosexually transmitted. There are a diverse range of male circumcision and penile modification practices across PNG. Exploring the implications of male circumcision for women in PNG is important to inform evidence-based health policy that will result in positive, intended consequences. The transformational grounded theory study incorporated participatory action research and decolonizing methodologies. In Phase One, an existing data set from a male circumcision study of 861 male and 519 female participants was theoretically sampled and analyzed for women's understanding and experience of male circumcision. In Phase Two of the study, primary data were co-generated with 64 women in seven interpretive focus group discussions and 11 semi-structured interviews...
Research Interests: Participatory Action Research, Focus Groups, Male Circumcision, Transformational Leadership, Grounded Theory, and 14 moreSexual Health, Papua New Guinea, Medicine, Humans, HIV and AIDS, Female, Male, Focus Group, Young Adult, Adult, Public health systems and services research, Sexual Partners, Paediatrics and reproductive medicine, and HIV infections
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ABSTRACT Partnerships of mutual benefit are often forged to confront a common challenge. One such challenge is how to address HIV in Australia’s nearest neighbour, Papua New Guinea (PNG). With a wide range of cultures, a largely rural... more
ABSTRACT Partnerships of mutual benefit are often forged to confront a common challenge. One such challenge is how to address HIV in Australia’s nearest neighbour, Papua New Guinea (PNG). With a wide range of cultures, a largely rural population and a host of other development issues, PNG is a tough environment in which to conduct public health research. In order to overcome some of these obstacles, researchers formed a collaboration between three universities: James Cook University in Australia, and the faith-based Papua New Guinean Universities of Pacific Adventist University and Divine Word University. This article describes that partnership, outlines our research capacity building activities and describes how colleagues become friends while contributing to the national and regional HIV response.
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Background: Papua New Guinea is a diverse country with a population of 6.8 million people speaking more than 800 languages. PNG has more than 90% of all reported cases of HIV in Oceania. Following trials that showed male circumcision... more
Background: Papua New Guinea is a diverse country with a population of 6.8 million people speaking more than 800 languages. PNG has more than 90% of all reported cases of HIV in Oceania. Following trials that showed male circumcision reduces the risk of heterosexual men acquiring HIV, MC is now recommended in comprehensive HIV prevention packages for populations with a heterosexual, generalised epidemic and where most men are not circumcised. The 'Acceptability and Feasibility of Male Circumcision for HIV Prevention in PNG' study documented reasons for penile cutting in four locations across PNG. Methods: Both men and women completed structured questionnaires about penile cutting. Sites were two university campuses in large urban centres, a remote mountain gold mine and coastal oil palm plantation. These are locations where people from across the country gather for work or study. The questionnaire included specific questions on the reasons for penile cutting. Results: 864 males and 560 females completed questionnaires. 57% of males reported some form of penile cutting. Reasons reported by men were both historical and contemporary: being a part of custom/tradition; cleanliness; peer influence; to increase the size of the penis; avoid STI; increase sexual pleasure; prolong sexual intercourse; perceived increase in female sexual pleasure. Conclusion: There was a diverse range of reasons for penile cutting reported in this study population. Any potential male circumcision for HIV prevention programs in Papua New Guinea need to take into account the wide range of traditional and contemporary penile cutting practices, and the reasons these cuts are being done.