The risk of HIV transmission may be increased by certain cultural practices. In Cameroon, these practices include group circumcision of boys using unsterile knives during rites of passage, skin cutting or tribal markings, group breast feeding practices and nose shaving rituals. Since traditional healers and circumcisers have a vital role in these practices at the village level, their collaboration is needed by government and biomedical communities to engage in health education and prevention efforts to stem HIV incidence and prevalence. Such efforts should include comprehensive education on HIV counseling, testing, condom use and male circumcision in health centers, clinics and hospitals. As more people emigrate to the U.S. from sub-Saharan countries where such cultural practices (including female circumcision) are endemic, health care providers need to identify and follow up potential health problems of these immigrants.

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