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

Gurman, Tilly; Dhillon, Preeti; Greene, Jessica; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

doi:10.1521/aeap.2015.27.2.153

Cited by 12 publications

(8 citation statements)

References 28 publications

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“…The ndings of this study indicated the circumcision prevalence (48.98%) was higher in this study than the recent global estimation of male circumcision which is at 37-39%, where almost half of these procedures are carried out for cultural or religious reasons (25,26). EmaSwati do not circumcise in the cultural context and some common myths including the foreskin making a certain spice, reduction of libido and the operation being very painful (27). The prevalence on this study is slightly higher than a self-reported prevalence of 42.8% done in South Africa (28).…”

Section: Discussionmentioning

confidence: 50%

Knowledge, attitudes and acceptance of voluntary medical male circumcision among males attending high school in Shiselweni region, Eswatini: a cross sectional study

Shezi

Tlou

Naidoo

2022

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Background In countries such as Eswatini, where there is a high HIV prevalence and low male circumcision the World Health Organization and the Joint United Nations Programme for HIV/AIDS recommend infant and adult circumcision be implemented. The aim of this study was to assess the knowledge, attitudes and acceptability of voluntary medical male circumcision amongst males attending high school in Eswatini. MethodsAn observational cross-sectional study was conducted during February and March of 2018 amongst 407 young males (15-21 years) attending Form 4, in nine high schools in the Shiselweni region of Eswatini using a self-administered questionnaire of 42 close ended questions. Sociodemographic details, circumcision status, acceptance of voluntary medical male circumcision, knowledge and attitude scores analysed in Stata® 14 statistical software were described using frequencies, medians and ranges respectively. Bivariate and multivariate linear regression was used to assess the impact of independent variables on circumcision status and acceptance of voluntary medical male circumcision. The level of statistical significance was p<0.05ResultsAmongst the 407 high school-going males, 48.98% (n= 201) reported being circumcised. The majority of the adolescents (75.74%; n= 306) were knowledgeable about voluntary medical male circumcision. However, an even larger majority (84.90% (n= 343) had a negative attitude towards it. In the multivariable logistic regression analysis, having parented their own children (OR: 3.55; 95%CI: 1.2 – 10.48), and having circumcised friends (OR: 3.99; 95%CI: 1.81 -8.84) were significantly associated with being circumcised. Neither knowledge nor attitude were associated with the acceptability of voluntary medical male circumcision.ConclusionIn Eswatini male high school students are knowledgeable about voluntary medical male circumcision, but have a negative attitude towards it. Having parented their own children, and having circumcised friends influenced being circumcised.

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Section: Discussionmentioning

confidence: 50%

Knowledge, attitudes and acceptance of voluntary medical male circumcision among males attending high school in Shiselweni region, Eswatini: a cross sectional study

Shezi

Tlou

Naidoo

2022

Preprint

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“…No studies have assessed perceived descriptive norms about male circumcision uptake in Uganda. Young uncircumcised men in eSwatini were more likely to report a personal intention to get circumcised if they thought that their friends, parents, or partner encouraged male circumcision and if they thought that most male friends were circumcised [72]. Similarly, young uncircumcised men in Zimbabwe were more likely to report a personal intention to get circumcised if they believed that their mother would encourage male circumcision and if they believed that male friends would get circumcised [73].…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Perceived norms about male circumcision and personal circumcision status: a cross-sectional, population-based study in rural Uganda

Perkins

Kakuhikire

Baguma

et al. 2023

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Introduction: Over the past decade, 15 high-priority countries in eastern and southern Africa have promoted voluntary medical male circucmsion for HIV and STI prevention. Despite male circumcision prevalence in Uganda nearly doubling from 26% in 2011 to 43% in 2016, it remained below the target level by 2020. Little is known about perceived norms of male circumcision and their association with circumcision uptake among men. Methods: We conducted a cross-sectional study targeting all adult residents across eight villages in Rwampara District, southwestern Uganda in 2020-2022. We compared what men and women thought was the adult male circumcision prevalence within their village (perceived norm: >50% (most), 10% to <50% (some), <10%, (few), or do not know) to the aggregated prevalence of circumcision as reported by men aged <50 years. We used a modified multivariable Poisson regression model to estimate the association between perceived norms about male circumcision uptake and personal circumcision status among men. Results: Overall, 167 (38%) men < 50 years old were circumcised (and 27% of all men were circumcised). Among all 1566 participants (91% response rate), 189 (27%) men and 177 (20%) women underestimated the male circumcision prevalence, thinking that few men in their own village had been circumcised. Additionally, 10% of men and 25% of women reported not knowing the prevalence. Men who underestimated the prevalence were less likely to be circumcised (aRR = 0.51, 95% CI 0.37 to 0.83) compared to those who thought that some village men were circumcised, adjusting for perceived personal risk of HIV, whether any same-household women thought most men were circumcised, and other sociodemographic factors. Conclusions: Across eight villages, a quarter of the population underestimated the local prevalence of male circumcision. Men who underestimated circumcision uptake were less likely to be circumcised. Future research should evaluate norms-based approaches to promoting male circumcision uptake. Strategies may include disseminating messages about the increasing prevalence of adult male circumcision uptake in Uganda and providing personalized normative feedback to men who underestimated local rates about how uptake is greater than they thought.

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“…In Mozambique, data from population-based surveys have contributed to estimating the prevalence of male circumcision among men, which assists in assessing if the target coverage of VMMC is being met. [9]. However, more information is necessary for determining the relative preventive benefits of traditional male circumcision in addition to MMC in preventing HIV infection.…”

Section: Introductionmentioning

confidence: 99%

Association between HIV/AIDS, Medical Male Circumcision and Traditional Circumcision in Mozambique, 2015

Militão,

Langa,

Braga

et al. 2023

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BackgroundThe WHO AFRO region continues to be severely impacted by HIV and a global public health problem. In Mozambique, as of 2015, HIV prevalence was estimated to be 12.5% among adults. Medical male circumcision (MMC) has been promoted as a national prevention strategy to reduce the risk of HIV in men. We aimed to analyze the association between HIV infection, medical male circumcision and traditional male circumcision among men in Mozambique.MethodsCross-sectional data from the 2015 Mozambican National and Demographic Health Survey of Immunization, Malaria, and HIV/AIDS (IMASIDA) were used in this analysis. In this study, considered medical male circumcision (MMC) and medical circumcision (MC). Participants were asked about their circumcision status and where the circumcision was performed. In addition, blood samples were collected from participants and tested for HIV antibodies. All analyses were weighted and adjusted for the complex survey design to ensure results and approximate population parameters of interest. Chi-square tests and multiple logistic regression were used in the analyses to assess the associations between male circumcision and HIV infection.ResultsA total unweighted sample of 4733 men aged 15-49 consented to the survey and were interviewed. Of those who participated, 4236 consented to an HIV test. Nationally, 62.6% (95% CI 59.6-65.6) of men aged 15-49 years were circumcised. Traditional circumcision was the most common form of circumcision at 32.9% (95% CI 30.1-35.8), followed by MMC at 21.7% (95% CI 19.6-24.1), 8.0% (95% CI 6.5-9.9) did not know whether it was traditional or medical. The prevalence of HIV was highest at 13.4% among uncircumcised men (13.4%, 95% CI 11.3-15.7), and significantly lower among traditionally circumcised men (8.5%, 95% CI 6.8-10.6) and among medically circumcised men (7.5%, 95% CI 5.7-9.6). In multivariable analysis, men circumcised by a medical practitioner had almost 50% reduced odds of infection with HIV compared to uncircumcised men (aOR=0.52; 95% [CI=0.34-0.78], p=0.002), whereas men who were circumcised by traditional methods had a 29% reduced risk, but not significantly different than uncircumcised men (aOR=0.71; 95% [CI=0.47-1.07], p=0.098).ConclusionWe found that HIV prevalence was lower among men aged 15-49 years who were circumcised, and the odds of being HIV positive was about 50% lower among men who were circumcised by a medical practitioner, suggesting a reduced risk of HIV infection. Although Mozambique has not achieved the UNAIDS goal of 80% men circumcised at the time of the IMASIDA 2015 survey, we encourage the continued expansion of voluntary medical male circumcision.

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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

Cited by 12 publications

References 28 publications

Knowledge, attitudes and acceptance of voluntary medical male circumcision among males attending high school in Shiselweni region, Eswatini: a cross sectional study

Knowledge, attitudes and acceptance of voluntary medical male circumcision among males attending high school in Shiselweni region, Eswatini: a cross sectional study

Perceived norms about male circumcision and personal circumcision status: a cross-sectional, population-based study in rural Uganda

Association between HIV/AIDS, Medical Male Circumcision and Traditional Circumcision in Mozambique, 2015

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