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Danda G, Mavundla T, Mudokwenyu-Rawdon C. The role of women in promoting voluntary medical male circumcision uptake: Literature review. Health SA 2022; 27:1794. [PMID: 35937423 PMCID: PMC9350443 DOI: 10.4102/hsag.v27i0.1794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/02/2022] [Indexed: 11/05/2022] Open
Abstract
Voluntary medical male circumcision (VMMC) is a global strategy for reducing female-to-male sexual transmission of HIV. Women whose partners are circumcised benefit from a reduced risk of contracting other sexually transmitted diseases; making their role in VMMC critical. The objective of our study was to identify and synthesize existing evidence related to women’s role in promoting VMMC from a regional perspective. The review and selection process were guided by the Problem; Intervention; Comparison and Outcome (PICO) model, which facilitated the exclusion of irrelevant studies. The search strategy search terms for the PICO components with synonyms, related terms and specialist terms were harvested from the Medical Subject Headings (MeSH)© and Embase©. The inclusion criteria were published studies in English and relevant to women’s role in VMMC for the prevention of HIV between 2007 and 2020. Four key categories emerged from the literature as follows: role of women, VMMC uptake, barriers and facilitators of VMMC. The majority of the studies concur on the importance of involving women in VMMC uptake as they have the power to negotiate with their male partners through communication and can persuade men to be circumcised, making it a joint decision. The benefits of VMMC in improving sexual pleasure and attractiveness of the penis seemed to positively convince women to influence and educate men to improve the uptake of VMMC. Women are motivated to convince men to undergo male circumcision (MC) because of the benefits associated with them such as reduction of HIV transmission and cervical cancer. There are, however, limited studies focusing on women’s involvement in VMMC; hence, more research to explore this area is recommended.
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Affiliation(s)
- Grace Danda
- Department of Nursing and Midwifery Sciences, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Thandisizwe Mavundla
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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Sangweni PN, Mavundla TR, Moabi PS. Factors hindering effective uptake of medical male circumcision at Untunjambili area in KwaZulu-Natal, South Africa. Health SA 2019; 24:1305. [PMID: 31934442 PMCID: PMC6917387 DOI: 10.4102/hsag.v24i0.1305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 06/11/2019] [Indexed: 11/29/2022] Open
Abstract
Background Before 19th century, in KwaZulu-Natal, South Africa, male circumcision was regarded as a right to passage to manhood; however, during the ruling of King Shaka Zulu, circumcision was abolished. It was only in 2010 that it was re-introduced, but this time in the form of medical male circumcision. The aim was to circumcise as many men as possible to avert new human immunodeficiency virus (HIV) infections, but few males utilise the circumcision services. Aim The aim of this study was to gain an understanding of the factors that hinder effective uptake of medical male circumcision. Setting This study was conducted at Untunjambili area under iLembe district in KwaZulu-Natal province. Methods This qualitative, exploratory, descriptive and contextual study was conducted using in-depth unstructured face-to-face individual interviews at Untunjambili area under iLembe district in KwaZulu-Natal. A convenience sampling method was employed and participants aged between 18 and 49 years participated in the study. Results Factors that hinder effective uptake of medical male circumcision are organised into five categories: (1) fear (fear of pain, fear of death, fear of HIV test and fear of delayed wound healing, (2) personal factors (age at circumcision, lack of role models, procrastination and lack of volition, fertility and faithfulness), (3) knowledge deficit on circumcision, (4) influence of culture and (5) natural circumcision. Conclusion Factors that hinder effective uptake of medical male circumcision services are manifold. Cultivating a positive attitude towards medical male circumcision can promote uptake of circumcision services and a supportive social support system of men needs to be utilised to encourage men to be circumcised.
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Affiliation(s)
- Promise N Sangweni
- Department of Health Studies, University of South Africa, Pretoria, South Africa
| | | | - Pule S Moabi
- Clinical Teaching Department, Scott College of Nursing, Morija, South Africa
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Grund JM, Bryant TS, Toledo C, Jackson I, Curran K, Zhou S, Del Campo JM, Yang L, Kivumbi A, Li P, Bock N, Taliano J, Davis SM. Association of Male Circumcision with Women's Knowledge of its Biomedical Effects and With Their Sexual Satisfaction and Function: A Systematic Review. AIDS Behav 2019; 23:1104-1114. [PMID: 30357642 PMCID: PMC6557870 DOI: 10.1007/s10461-018-2313-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Male circumcision (MC) is a key HIV prevention intervention for men in countries with high HIV prevalence. Women's understanding of MC is important but poorly understood. We conducted a systematic review including women's knowledge of MC's biomedical impacts and its association with female sexual satisfaction and function through October 2017. Thirty-eight articles were identified: thirty-two with knowledge outcomes, seven with sexual satisfaction, and four with sexual function (N = 38). Respondent proportions aware MC protects men from HIV were 9.84-91.8% (median 60.0%). Proportions aware MC protects men from STIs were 14.3-100% (72.6%). Proportions aware MC partially protects men from HIV were 37.5-82% (50.7%). Proportions aware MC is not proven to protect women from infection by an HIV-positive partner were 90.0-96.8% (93.0%). No increases over time were noted. Women's MC knowledge is variable. Education could help women support MC and make better-informed sexual decisions.
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Affiliation(s)
- Jonathan M Grund
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Tyler S Bryant
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carlos Toledo
- Division of Global HIV and TB, HIV Prevention Branch, US Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E04, Atlanta, GA, 30329, USA
| | - Inimfon Jackson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Sheng Zhou
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ling Yang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Apollo Kivumbi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peizi Li
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Naomi Bock
- Division of Global HIV and TB, HIV Prevention Branch, US Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E04, Atlanta, GA, 30329, USA
| | - Joanna Taliano
- Division of Public Health Information Dissemination (DPHID), Library Science Branch, Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), Atlanta, GA, USA
| | - Stephanie M Davis
- Division of Global HIV and TB, HIV Prevention Branch, US Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E04, Atlanta, GA, 30329, USA.
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Nakyanjo N, Piccinini D, Kisakye A, Yeh PT, Ddaaki W, Kigozi G, Gray RH, Kennedy CE. Women's role in male circumcision promotion in Rakai, Uganda. AIDS Care 2018; 31:443-450. [PMID: 30010413 DOI: 10.1080/09540121.2018.1500009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Medical male circumcision (MMC) has expanded in sub-Saharan Africa, yet uptake remains sub-optimal. We sought to understand women's perceptions of and influence on MMC in Rakai, Uganda. We conducted in-depth interviews with 27 women in fishing and trading communities, including women married to circumcised and uncircumcised men, single women, and sex workers. Data analysis followed a team-based framework approach. All female participants preferred circumcised men because of perceived reduced HIV and sexually transmitted infection (STI) risk, improved penile hygiene, and increased sexual pleasure. Perceived negative aspects included abstinence during wound healing, potentially increased male sexual risk behaviors, fear of being blamed for HIV acquisition, and economic insecurity due to time off work. Participants felt women could persuade their partners to be circumcised, accompany them to the clinic, refuse sex with uncircumcised men, and participate in community MMC activities. Findings support women's important role in MMC acceptance.
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Affiliation(s)
- Neema Nakyanjo
- a Social and Behavioral Sciences Department , Rakai Health Sciences Program, Research Directorate , Kalisizo , Uganda
| | - Danielle Piccinini
- b Center for Communications Programs , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Alice Kisakye
- c Rakai Health Sciences Program, Programs Directorate , Kalisizo , Uganda
| | - Ping Teresa Yeh
- d Department of International Health, Social and Behavioral Interventions Program , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - William Ddaaki
- a Social and Behavioral Sciences Department , Rakai Health Sciences Program, Research Directorate , Kalisizo , Uganda
| | - Godfrey Kigozi
- e Rakai Health Sciences Program, Research Directorate , Kalisizo , Uganda
| | - Ronald H Gray
- f Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Caitlin E Kennedy
- d Department of International Health, Social and Behavioral Interventions Program , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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Female Partner Acceptance as a Predictor of Men's Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project. AIDS Behav 2016; 20:2503-2513. [PMID: 25931242 DOI: 10.1007/s10461-015-1079-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The World Health Organization has recommended the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in sub-Saharan Africa; however, men are often uninterested in undergoing VMMC. The Spear & Shield project enrolled 668 men and female partners from ten Zambian community health centers into parallel interventions promoting VMMC for HIV prevention or time-matched control conditions. A mediation model was utilized to examine the relationships between changes in women's acceptance of VMMC and men's readiness to undergo the procedure. Results demonstrated that, at 12 months post-intervention, a 5.9 % increase in the likelihood of undergoing VMMC among men in the experimental condition could be attributed to increased women's acceptance. From a public health perspective, involving women in VMMC promotion interventions such as the Spear & Shield project could significantly impact the demand for VMMC in Zambia.
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Mati K, Adegoke KK, Salihu HM. Factors associated with married women's support of male circumcision for HIV prevention in Uganda: a population based cross-sectional study. BMC Public Health 2016; 16:696. [PMID: 27484177 PMCID: PMC4971618 DOI: 10.1186/s12889-016-3385-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the protective effect of male circumcision (MC) against HIV in men, the acceptance of voluntary MC in priority countries for MC scale-up such as Uganda remains limited. This study examined the role of women's sociodemographic characteristics, knowledge of HIV and sexual bargaining power as determinants of women's support of male circumcision (MC). METHODS Data from the Uganda AIDS Indicator Survey, 2011 were analyzed (n = 4,874). Bivariate and multivariate logistic regression analyses with random intercept were conducted to identify factors that influence women's support of MC. RESULTS Overall, 67.0 % (n = 3,276) of the women in our sample were in support of MC but only 28.0 % had circumcised partners. Women who had the knowledge that circumcision reduces HIV risk were about 6 times as likely to support MC than women who lacked that knowledge [AOR (adjusted odds ratio) = 5.85, 95 % CI (confidence interval) = 4.83-7.10]. The two indicators of women's sexual bargaining power (i.e., ability to negotiate condom use and ability to refuse sex) were also positively associated with support of MC. Several sociodemographic factors particularly wealth index were also positively associated with women's support of MC. CONCLUSIONS The findings in this study will potentially inform intervention strategies to enhance uptake of male circumcision as a strategy to reduce HIV transmission in Uganda.
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Affiliation(s)
- Komi Mati
- Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL USA
| | - Korede K. Adegoke
- Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL USA
| | - Hamisu M. Salihu
- Department of Family and Community Health, Baylor College of Medicine, Houston, TX USA
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Redding CA, Jones D, Zulu R, Chitalu N, Cook R, Weiss SM. Stages of Change for Voluntary Medical Male Circumcision and Sexual Risk Behavior in Uncircumcised Zambian Men: The Spear and Shield Project. Int J Behav Med 2016; 22:799-806. [PMID: 25896876 DOI: 10.1007/s12529-015-9485-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Dissemination and scale up of voluntary medical male circumcision (VMMC) programs is well supported by evidence that VMMC reduces HIV risk in populations with high HIV prevalence and low rates of circumcision, as is the case in Zambia. PURPOSE At both individual and population levels, it is important to understand what stages of change for VMMC are associated with, especially across cultures. This study evaluated VMMC knowledge, misinformation, and stages of change for VMMC of uncircumcised men and boys (over 18 years), as well as the concurrent relationship between VMMC stages of change and sexual risk behaviors. METHOD Uncircumcised (N = 800) adult men and boys (over 18) were screened and recruited from urban community health centers in Lusaka, Zambia, where they then completed baseline surveys assessing knowledge, attitudes, HIV risk behaviors, and stages of change for VMMC. A series of analyses explored cross-sectional relationships among these variables. RESULTS VMMC was culturally acceptable in half of the sample; younger, unmarried, and more educated men were more ready to undergo VMMC. Stage of change for VMMC was also related to knowledge, and those at greater HIV risk reported greater readiness to undergo VMMC. CONCLUSIONS Efforts to increase VMMC uptake should address the role of perceived HIV risk, risk behaviors, readiness, accurate knowledge, cultural acceptance, and understanding of the significant degree of HIV protection conferred as part of the VMMC decision making process. These results support incorporating comprehensive HIV risk reduction in VMMC promotion programs.
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Affiliation(s)
- Colleen A Redding
- University of Rhode Island, 130 Flagg Rd., Kingston, RI, 02881, USA.
| | - Deborah Jones
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Zulu
- University of Zambia School of Medicine, Lusaka, Zambia
| | | | - Ryan Cook
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephen M Weiss
- University of Miami Miller School of Medicine, Miami, FL, USA
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Zulu R, Jones D, Chitalu N, Cook R, Weiss S. Sexual Satisfaction, Performance, and Partner Response Following Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project. GLOBAL HEALTH: SCIENCE AND PRACTICE 2015; 3:606-18. [PMID: 26681707 PMCID: PMC4682585 DOI: 10.9745/ghsp-d-15-00163] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 10/21/2015] [Indexed: 02/06/2023]
Abstract
Most men and their partners reported increased or the same levels of sexual pleasure and improved or no change in penile hygiene post-VMMC. While half of men reported increased or no change in sexual functioning (orgasm, erections), one-third reported a decrease. Early resumption of sexual intercourse prior to complete healing was most closely associated with adverse outcomes, including decreased sexual functioning, satisfaction, and desire. Background: Voluntary medical male circumcision (VMMC) is an important HIV prevention strategy, particularly in regions with high HIV incidence and low rates of male circumcision. However, 88% of the Zambian male population remain uncircumcised, and of these 80% of men surveyed expressed little interest in undergoing VMMC. Methods: The Spear and Shield study (consisting of 4 weekly, 90-minute sexual risk reduction/VMMC promotion sessions) recruited and enrolled men (N = 800) who self-identified as at risk of HIV by seeking HIV testing and counseling at community health centers. Eligible men tested HIV-negative, were uncircumcised, and expressed no interest in VMMC. Participants were encouraged (but not required) to invite their female partners (N = 668) to participate in the program in a gender-concordant intervention matched to their partners’. Men completed assessments at baseline, post-intervention (about 2 months after baseline), and 6 and 12 months post-intervention; women completed assessments at baseline and post-intervention. For those men who underwent VMMC and for their partners, an additional assessment was conducted 3 months following the VMMC. The ancillary analysis in this article compared the pre- and post-VMMC responses of the 257 Zambian men who underwent circumcision during or following study participation, using growth curve analyses, as well as of the 159 female partners. Results: Men were satisfied overall with the procedure (mean satisfaction score, 8.4 out of 10), and nearly all men (96%) and women (94%) stated they would recommend VMMC to others. Approximately half of the men reported an increase or no change in erections, orgasms, and time to achieve orgasms from pre-VMMC, while one-third indicated fewer erections and orgasms and decreased time to achieve orgasms post-VMMC. Nearly half (42%) of the men, and a greater proportion (63%) of the female partners, said their sexual pleasure increased while 22% of the men reported less sexual pleasure post-VMMC. Growth curve analysis of changes in sexual functioning and satisfaction over time revealed no changes in erectile functioning or intercourse satisfaction, but there were increases in orgasm functioning, overall sexual satisfaction, and sexual desire. The majority (61% to 70%) of men and women thought penile cleanliness and appearance had improved post-VMMC. Of the 69% of men who reported having sexual intercourse at least once between having the procedure and their 3-month post-VMMC assessment, the large majority (76%) waited at least 6 weeks before resuming sex. Sexual intercourse prior to the 6-week healing period was associated with adverse events and lower levels of post-VMMC sexual satisfaction. Conclusion: Both men and their partners can generally expect equal or improved sexual satisfaction and penile hygiene following VMMC. Future studies should consider innovative strategies to assist men in their efforts to abstain from sexual activities prior to complete healing.
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Affiliation(s)
- Robert Zulu
- University of Zambia School of Medicine, Lusaka, Zambia
| | - Deborah Jones
- University of Miami Miller School of Medicine, Psychiatry and Behavioral Sciences, Miami, FL, USA
| | | | - Ryan Cook
- University of Miami Miller School of Medicine, Psychiatry and Behavioral Sciences, Miami, FL, USA
| | - Stephen Weiss
- University of Miami Miller School of Medicine, Psychiatry and Behavioral Sciences, Miami, FL, USA
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Gurman TA, Dhillon P, Greene JL, Makadzange P, Khumlao P, Shekhar N. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:153-166. [PMID: 25915700 DOI: 10.1521/aeap.2015.27.2.153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = < .007), a Christian man should not get circumcised (OR = 2.47; p < .001), and circumcision makes penetration more painful and difficult (OR = 2.44; p = .007). Several beliefs about enhanced sexual performance, normative beliefs (parents, sexual partner, and friends), and non-TRA-related factors (e.g., importance of plowing season to daily schedule) were also statistically significant predictors. TRA proved a useful theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC.
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Jones D, Cook R, Arheart K, Redding CA, Zulu R, Castro J, Weiss SM. Acceptability, knowledge, beliefs, and partners as determinants of Zambian men's readiness to undergo medical male circumcision. AIDS Behav 2014; 18:278-84. [PMID: 23757123 DOI: 10.1007/s10461-013-0530-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is limited information about the influence of partners on medical male circumcision (MMC) uptake. This study aimed to evaluate attitudes, knowledge, and preferences about MMC among men and their partners, and their relative impact on male readiness to undergo the MMC procedure. Male participants (n = 354) and their partners (n = 273) were recruited from community health centers in Lusaka, Zambia. Men reported their readiness to undergo MMC, and both men and women were assessed regarding their attitudes and knowledge regarding MMC. Men who had discussed MMC with their partners, those who endorsed MMC for HIV risk reduction, and those viewing MMC as culturally acceptable reported increased readiness to undergo MMC. Additionally, endorsement of MMC by female partners was associated with increased men's readiness. Results support promotion of cultural acceptability of MMC, and efforts to increase MMC uptake may benefit from incorporating partners in the decision making process.
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Affiliation(s)
- Deborah Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave. Suite 404A, Miami, FL, 33136, USA,
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Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda. PLoS One 2011; 6:e22254. [PMID: 21799805 PMCID: PMC3140501 DOI: 10.1371/journal.pone.0022254] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 06/17/2011] [Indexed: 11/21/2022] Open
Abstract
Introduction The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future. Methods We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission) attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods. Results 318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men's risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14) and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07) were significantly (p≤0.05) more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004) and those who were HIV seropositive (APR 1.09, p = 0.03) were also more likely to be interested in child circumcision for HIV prevention. Conclusions A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.
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