Factors Associated With Uptake of Infant Male Circumcision for HIV Prevention in Western Kenya

Young, M. R.; Odoyo-June, Elijah; Nordstrom, Sherry K.; Irwin, Tracy; Ongong'a, Dedan O.; Ochomo, Betha; Agot, Kawango; Bailey, Robert C.

doi:10.1542/peds.2011-2290

Cited by 28 publications

(42 citation statements)

References 30 publications

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“…These findings are consistent with those from other settings [27–30]. A study conducted in Mysore, India also found that the father has the final say in whether the infant is circumcised or not [27].…”

Section: Discussionsupporting

confidence: 89%

“…A study conducted in Mysore, India also found that the father has the final say in whether the infant is circumcised or not [27]. Within sub-Saharan Africa, the findings are consistent with those from Western Kenya and Zambia [28, 30]. In the Kenyan study, fathers of babies who had undergone EIMC were the primary decision makers in most instances, according to interviews with mothers and fathers [30].…”

Section: Discussionmentioning

confidence: 64%

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Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe

Mavhu

Hatzold²,

Ncube

et al. 2017

BMC Int Health Hum Rights

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BackgroundEarly infant male circumcision (EIMC) has been identified as a key HIV prevention intervention. Exploring the decision-making process for adoption of EIMC for HIV prevention among parents and other key stakeholders is critical for designing effective demand creation interventions to maximize uptake, roll out and impact in preventing HIV. This paper describes key players, decisions and actions involved in the EIMC decision-making process.MethodsTwo complementary qualitative studies explored hypothetical and actual acceptability of EIMC in Zimbabwe. The first study (conducted 2010) explored hypothetical acceptability of EIMC among parents and wider family through focus group discussions (FGDs, n = 24). The follow-up study (conducted 2013) explored actual acceptability of EIMC among parents through twelve in-depth interviews (IDIs), four FGDs and short telephone interviews with additional parents (n = 95). Short statements from the telephone interviews were handwritten. FGDs and IDIs were audio-recorded, transcribed and translated into English. All data were thematically coded.ResultsStudy findings suggested that EIMC decision-making involved a discussion between the infant’s parents. Male and female participants of all age groups acknowledged that the father had the final say. However, discussions around EIMC uptake suggested that the infant’s mother could sometimes covertly influence the father's decision in the direction she favoured. Discussions also suggested that fathers who had undergone voluntary medical male circumcision were more likely to adopt EIMC for their sons, compared to their uncircumcised counterparts. Mothers-in-law/grandparents were reported to have considerable influence. Based on study findings, we describe key EIMC decision makers and attempt to illustrate alternative outcomes of their key actions and decisions around EIMC within the Zimbabwean context.ConclusionsThese complementary studies identified critical players, decisions and actions involved in the EIMC decision-making process. Findings on who influences decisions regarding EIMC in the Zimbabwean context highlighted the need for EIMC demand generation interventions to target fathers, mothers, grandmothers, other family members and the wider community.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 64%

Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe

Mavhu

Hatzold²,

Ncube

et al. 2017

BMC Int Health Hum Rights

View full text Add to dashboard Cite

show abstract

“…It is possible that even men who do not accept circumcision for themselves (i.e., because of fear of pain or lost income after the procedure) will still desire the procedure for their sons, whereas the mother's support of EIMC may be more greatly affected by the circumcision status of the father. Previous research in sub Saharan Africa and elsewhere indicates circumcision status of the father is associated with maternal desire for the procedure ( Ref 13,15,32]. Given just twelve percent of mothers had talked with her partner about EIMC, it is possible that, in the absence of discussion, mothers assume an uncircumcised father will not desire circumcision for his son.…”

Section: Discussionmentioning

confidence: 98%

“…After a ''catch-up'' period of circumcising adolescent and adult males who are at highest risk of acquiring HIV in the short term, several governments including the Government of Kenya, intend to scaleup EIMC for cost-efficient HIV prevention ( Ref 11]. EIMC studies and/or service provision have begun in Botswana, Kenya, Lesotho, Swaziland, Uganda, Zambia and Zimbabwe ( Ref 8,[12][13][14][15][16]. Previous acceptability studies have indicated several common barriers to EIMC services in east and Southern Africa including: fear of pain, bleeding, death and other adverse events associated with the procedure, and cultural opposition to EIMC ( Ref 17].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Preference for Early Infant Male Circumcision Among a Representative Sample of Parents in Homa Bay County, Western Kenya

et al. 2016

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Several countries scaling-up adult medical male circumcision (MMC) for HIV prevention intend to introduce early infant male circumcision (EIMC). To assess preference for EIMC in a community with a mature adult MMC program, we conducted a cross-sectional survey of a representative sample of mothers (n = 613) and fathers (n = 430) of baby boys ("index son") at 16 health facilities in western Kenya. Most (59 %) were for EIMC, generally. Just 29 % were for circumcising the index son. Pain and protection from HIV were the most frequently cited barrier and facilitator to EIMC, respectively. In multivariable logistic regression, ever talking with the partner about EIMC and positive serostatus were associated with preference for EIMC for the index son. Attitudes towards EIMC are favorable. Willingness to circumcise an infant son is modest. To facilitate EIMC uptake, education about EIMC pain management and encouraging discussion between parents about EIMC during pregnancy should be integrated into programs.

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“…However in Europe it is rarely performed [12]. The notable advantages of circumcision include: reduction in early childhood urinary tract infections, which is also noted in adult men [13–17], reduction of HIV transmission by almost 60 % [18–21], and reduction in the incidence of penile cancer [22–24]. Ghana’s circumcision rate is estimated to be on the high side as the majority of ethnic groups and religions identify circumcision as an appropriate religious or cultural practice for males to undergo [7].…”

Section: Discussionmentioning

confidence: 99%

Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

et al. 2016

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BackgroundCircumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.MethodsThe study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi. Consecutive cases of circumcision-related injuries seen at the unit over an 18 month period were identified and included in the study. Data was collected using a structured questionnaire. Data was entered and analysed using SPSS version 16. Charts and tables were generated using Microsoft Excel.ResultsA total of 72 cases of circumcision-related injuries were recorded during the 18 month period. Urethrocutaneous fistula was the commonest injury recorded, accounting for 77.8 % of cases. Other injuries recorded were glans amputations (6.9 %); iatrogenic hypospadias (5.6 %), and epidermal inclusion cysts (2.8 %). The majority of children were circumcised in health facilities (75 %) and nurses were the leading providers (77.8 %). The majority of circumcisions were conducted in the neonatal period (94.7 %).ConclusionCircumcision-related injuries commonly occurred in the neonatal period. Most of the injuries happened in health facilities. The most common injury recorded was urethrocutaneous fistula but the most tragic was penile amputation. There is the need for education and training of providers to minimise circumcision-related injuries in Ghana.

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Factors Associated With Uptake of Infant Male Circumcision for HIV Prevention in Western Kenya

Abstract: Fathers are important in the IMC decision-making process. Fathers, as well as mothers, should be targeted for optimal scale-up of IMC services. Circumcision programs should offer services for males of all ages, as male circumcision at some age is highly acceptable to both men and women.

Cited by 28 publications

References 30 publications

Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe

Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe

Factors Associated with Preference for Early Infant Male Circumcision Among a Representative Sample of Parents in Homa Bay County, Western Kenya

Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

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