VMMC clients’ perception of increased risk of HIV infection, circumcision preferred choice of method, providers’ socio-demographics and mode of service delivery

Abstract

Introduction: Voluntary medical male circumcision (VMMC) is a scientifically proven HIV prevention intervention. Uganda, like many countries has been implementing VMMC for over 10 years but uptake is still low especially in northern Uganda. To attain 80% needed for public health impact, scale-up was recommended with many innovations implemented with sub-optimal results. This study therefore wanted to find out some of the correlates of VMMC uptake in Gulu district, northern Uganda.
 Methods: Two studies were conducted separately but data was analyzed for this study. For the quantitative study, propor- tions and frequencies were used to measure perception of increased risk of HIV infection using age, gender, occupation, marital and circumcision status. Qualitative study provided data from FGDs, IDIs and KIIs were first transcribed in Acholi and then translated in English. Transcripts were uploaded in MAXDQA software for data management. A code book for emerging themes was developed.
 Results: A total of 548 respondents were interviewed for the quantitative study, where two thirds (66%) of the participants perceived themselves to be at increased risk of HIV infection. For the qualitative study, 149 participants from 19 FGDs, 11 KIIs and 9 IDIs were interviewed. Data were analyzed thematically using both inductive and deductive approaches. Devices were preferred to conventional surgery while mobile services were preferred to static services. However, there were diver- gent views regarding circumcision service providers’ socio-demographics and these were influenced mainly by age, level of education and location.
 Conclusion: People in Northern Uganda perceived themselves to be at an increased risk of HIV infection. They preferred devices to conventional surgery, mobile services to static services but had varying views about the socio-demographics of the service providers.
 Keywords: Male circumcision; challenges; HIV prevention.

Knowledge, Perception, and Practice of Safe Medical Circumcision on HIV Infection Risk Reduction among Undergraduate Students of a Public University in Northern Uganda: A Cross-Sectional Study

“…In an attempt to meet the world's commitment to ending the AIDS epidemic by 2030 [ 2 ], the WHO recommended SMC as one of the HIV prevention measures. The Ugandan government expected to have circumcised 6.9 million men aged 10-49 by 2020, though by 2016, only 2.5 million men had circumcised and there has never been a great mass safe male circumcision as it was in 2014 [ 3 ]. Recent studies have shown that there is a very high increase in the prevalence of HIV among the youth aged 20–24 years in Uganda standing at 10.8% [ 4 ], almost doubling the national prevalence of HIV in Uganda at 6.2% [ 5 ].…”

“…There is a high HIV prevalence in the Northern Uganda region with a 7.2% prevalence of HIV compared to the national prevalence of 6.2% [ 5 ]. There is also a growing number of males opting out of circumcision since 2016 up to today [ 3 ]; however, younger males remain reluctant to undertake this voluntary initiative. This coupled with the limited numbers of young people undertaking HIV testing and other sexual and reproductive health services in Northern Uganda of about 43% and 42%, respectively, poses a significant challenge in the fight against HIV/AIDS and other sexually transmitted infections [ 6 , 7 ].…”

Editor’s choice: this December 2020

“…Then follows the attempt by the HIV community to understand the ramifications of the HIV pandemic in Africa despite having lived with it for almost 4 decades now! Hence we have papers on: outcomes on PLHIV in Kenya 4 CD4 counts, 5 VMMC and HIV risk in Uganda, 6 HIV and fungal infection 7 , HIV in Wuhan China 8 that city that gave Covid-19 to the world; and HIV and primary school teachers. 9 Then comes dengue, 10 hepatitis B and osteoporosis, 11 TB, 12 H.pylori , 13 MDR Staph.…”