Designing Family-Centered Male Circumcision Services

Bridges, John F.P.; Searle, Sarah C.; Selck, Frederic; Martinson, Neil

doi:10.2165/11592970-000000000-00000

Cited by 10 publications

(14 citation statements)

References 22 publications

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“…This was also similar to some studies in Africa where education and awareness of female partners or mothers in the uptake of MC was considered important [16,87-89]. Awareness is knowledge empowerment that includes clear understanding of health service purpose as well as key aspects of program requirements.…”

Section: Discussionsupporting

confidence: 81%

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

et al. 2013

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BackgroundThe success of health programs is influenced not only by their acceptability but also their ability to meet and respond to community expectations of service delivery. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended medical male circumcision (MC) as an essential component of comprehensive HIV prevention programs in high burden settings. This study investigated community-level perceptions of MC for HIV prevention in Papua New Guinea (PNG), a setting where diverse traditional and contemporary forms of penile foreskin cutting practices have been described.MethodsA multi-method qualitative study was undertaken in four provinces in two stages from 2009 to 2011. A total of 82 in-depth interviews, and 45 focus group discussions were completed during Stage 1. Stage 2 incorporated eight participatory workshops that were an integral part of the research dissemination process to communities. The workshops also provided opportunity to review key themes and consolidate earlier findings as part of the research process. Qualitative data analysis used a grounded theory approach and was facilitated using qualitative data management software.ResultsA number of diverse considerations for the delivery of MC for HIV prevention in PNG were described, with conflicting views both between and within communities. Key issues included: location of the service, service provider, age eligibility, type of cut, community awareness and potential shame amongst youth. Key to developing appropriate health service delivery models was an appreciation of the differences in expectations and traditions of unique cultural groups in PNG. Establishing strong community coalitions, raising awareness and building trust were seen as integral to success.ConclusionsDifficulties exist in the implementation of new programs in a pluralistic society such as PNG, particularly if tensions arise between biomedical knowledge and medico-legal requirements, compared to existing socio-cultural interests. Community participatory approaches offer important opportunities to explore and design culturally safe, specific and accessible programs.

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Section: Discussionsupporting

confidence: 81%

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

et al. 2013

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“…A systematic review of 17 studies addressing the effectiveness of youth centers—facilities specifically created to accommodate the needs of adolescents—in increasing SRH service uptake found these centers were rated poorly by youth when they lacked privacy [ 49 ]. In another VMMC-specific study in South Africa, fathers, mothers, and sons all valued private waiting rooms when seeking service delivery [ 50 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fear of pain was reported as a significant barrier to performing VMMC among male adolescents in Botswana, Rwanda, South Africa, and Uganda [ 50 , 69 – 71 ]. Male adolescents in Tanzania and South Africa were also concerned with the pain resulting from the breakage of stitches if they have an erection during the healing phase [ 35 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the same South African study, better pain management was shown to be a facilitator for VMMC among male adolescents when compared to traditional non-medical circumcision [ 37 ]. Studies from South Africa and Zimbabwe indicated HIV testing also created a barrier to VMMC for male adolescents who feared a positive result and subsequent stigma [ 37 , 50 , 72 ], especially when conducted during in-school recruitment, where male adolescents thought their test results would be immediately known to everyone [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…VMMC messages properly targeted toward adolescents are key for successful service uptake and satisfaction, and eleven articles addressed this topic [ 37 , 50 , 62 , 71 , 72 , 75 , 83 , 95 , 101 , 104 , 106 ]. A study in Zimbabwe and South Africa found that lack of information and misconceptions about benefits of VMMC (including impact of the intervention on reducing HIV and STIs for both men and women) were the key barriers to seeking VMMC among both adults and adolescents [ 101 ].…”

Section: Resultsmentioning

confidence: 99%

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Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review

et al. 2016

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BackgroundVoluntary medical male circumcision (VMMC) is a critical HIV prevention tool. Since 2007, sub-Saharan African countries with the highest prevalence of HIV have been mobilizing resources to make VMMC available. While implementers initially targeted adult men, demand has been highest for boys under age 18. It is important to understand how male adolescents can best be served by quality VMMC services.Methods and FindingsA systematic literature review was performed to synthesize the evidence on best practices in adolescent health service delivery specific to males in sub-Saharan Africa. PubMed, Scopus, and JSTOR databases were searched for literature published between January 1990 and March 2014. The review revealed a general absence of health services addressing the specific needs of male adolescents, resulting in knowledge gaps that could diminish the benefits of VMMC programming for this population. Articles focused specifically on VMMC contained little information on the adolescent subgroup. The review revealed barriers to and gaps in sexual and reproductive health and VMMC service provision to adolescents, including structural factors, imposed feelings of shame, endorsement of traditional gender roles, negative interactions with providers, violations of privacy, fear of pain associated with the VMMC procedure, and a desire for elements of traditional non-medical circumcision methods to be integrated into medical procedures. Factors linked to effective adolescent-focused services included the engagement of parents and the community, an adolescent-friendly service environment, and VMMC counseling messages sufficiently understood by young males.ConclusionsVMMC presents an opportune time for early involvement of male adolescents in HIV prevention and sexual and reproductive health programming. However, more research is needed to determine how to align VMMC services with the unique needs of this population.

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Risk as an Attribute in Discrete Choice Experiments: A Systematic Review of the Literature

Harrison

Rigby

Vass

et al. 2014

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Designing Family-Centered Male Circumcision Services

Abstract: Our findings suggest that valuation of aspects of MC clinic design can diverge by decision maker. To better ensure utilization of services, these variations should be taken into account to prior to implementation of a national strategy in South Africa.

Cited by 10 publications

References 22 publications

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review

Risk as an Attribute in Discrete Choice Experiments: A Systematic Review of the Literature

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