Predictors of voluntary medical male circumcision prevalence among men aged 25-39 years in Nyanza region, Kenya: Results from the baseline survey of the TASCO study

Abstract

IntroductionUptake of voluntary medical male circumcision (VMMC) as an intervention for prevention of HIV acquisition has been low among men aged !25 years in Nyanza region, western Kenya. We conducted a baseline survey of the prevalence and predictors of VMMC among men ages 25-39 years as part of the preparations for a cluster randomized controlled trial (cRCT) called the Target, Speed and Coverage (TASCO) Study. The TASCO Study aimed to assess the impact of two demand creation interventions-interpersonal communication (IPC) and dedicated service outlets (DSO), delivered separately and together (IPC + DSO)-on VMMC uptake. MethodsAs part of the preparatory work for implementation of the cRCT to evaluate tailored interventions to improve uptake of VMMC, we conducted a survey of men aged 25-39 years from a traditionally non-circumcising Kenyan ethnic community within non-contiguous locations selected as study sites. We determined their circumcision status, estimated the baseline circumcision prevalence and assessed predictors of being circumcised using univariate and multivariate logistic regression. ResultsA total of 5,639 men were enrolled of which 2,851 (50.6%) reported being circumcised. The odds of being circumcised were greater for men with secondary education (adjusted Odds Ratio (aOR) = 1.65; 95% CI: 1.45-1.86, p<0.001), post-secondary education (aOR = 1.72; 95% CI: 1.44-2.06, p <0.001), and those employed (aOR = 1.32; 95% CI: 1.

HIV prevalence, spatial distribution and risk factors for HIV infection in the Kenyan fishing communities of Lake Victoria

“…Interestingly, despite the government's efforts to scale up VMMC in the four counties predominantly inhabited by the Luo community, the coverage in the fishing communities is still low at 46% compared to the regional coverage of 71% and desired program target of 80%[62, 63]. Recent studies conducted by Akullian and colleagues in 2014 and Odoyo-June and colleagues in 2015 show less than five percentage point increase in VMMC coverage in the general population in Nyanza region compared to the data we obtained in this study[64, 65]. Even then, the larger part of this increase was accounted for by in- school youth who are thought to be relatively easy to mobilize and are likely to accept the service.…”

Prevalence of male circumcision in four culturally non-circumcising counties in western Kenya after 10 years of program implementation from 2008 to 2019

“…Specifically, having a higher level of education, being aged 15-24 years and being of Luo ethnic community were associated with being circumcised. These findings are consistent with the results of a similar survey conducted in the same counties in 2014-2015 among men aged 25-29 years [23]. In that study, higher education and having employment were associated with being circumcised, and having ever been married (currently married, divorced, separated, or widowed) was associated with being uncircumcised.…”

Messaging Circumstances and Economic Pressures as Influences on Linkage to Medical Male Circumcision following Community-Based HIV Testing for Men in Rural Southwest Uganda: A Qualitative Study

“…Finally, concern over gaps in income associated with recovery from the circumcision procedure highlights the importance of missed work as a barrier to uptake in low resource settings. Elsewhere, unemployed men and informal wage earners have expressed concern about missed work [ 29 ]. Our data shows that men with families and agricultural day labourers who rely on their physical strength to generate income are particularly vulnerable to this barrier.…”