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Barriers, benefits, and behaviour: Voluntary medical male circumcision ideation in a population-based sample of Zambian men.
Rosen, Joseph G; Carrasco, Maria A; Traub, Ariana M; Kumoji, E 'Kuor.
Afiliación
  • Rosen JG; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
  • Carrasco MA; Office of Family Planning and Reproductive Health, United States Agency for International Development, Washington DC, USA.
  • Traub AM; Office of HIV/AIDS, United States Agency for International Development, Washington DC, USA.
  • Kumoji E'; Research and Evaluation Division, Johns Hopkins Center for Communication Programs, Baltimore, USA.
Afr J AIDS Res ; 20(4): 314-323, 2021 Dec.
Article en En | MEDLINE | ID: mdl-34905454
Reaching ambitious voluntary medical male circumcision (VMMC) coverage targets requires a deeper understanding of the multifaceted processes shaping men's willingness to access VMMC. Guided by the Ideation Model for Health Communication, this population-based study identifies correlates of Zambian men's future VMMC intentions. Multistage cluster sampling was used to identify households with adult men in 14 districts. Multivariable Poisson regression with robust standard errors modelled associations of future VMMC intent with ideational factors (e.g. perceived benefits and barriers) and sexual behaviours respectively. Forty per cent (40%) of uncircumcised men (N = 1 204) expressed future VMMC intentions. In multivariable analysis, VMMC intent was associated with secondary education or higher (Adjusted Prevalence Ratio [APR] 1.30, 95% Confidence Interval [95% CI]: 1.02-1.66), perceiving VMMC to increase sexual satisfaction (APR 1.45, 95% CI: 1.11-1.89), reporting distance to services as a barrier to VMMC uptake (APR = 0.54, 95% CI: 1.27-1.87), unprotected last sex (APR 1.54, 95% CI: 1.11-2.14), and ≥ 2 sexual partners in the past 12 months (APR 1.45, 95% CI: 1.05-1.99). Being aged ≥ 45 years (vs 18-24 years: APR 0.23, 95% CI: 0.13-0.40) and perceiving that circumcision: (1) is unimportant (APR 0.71, 95% CI: 0.51-0.98); (2) is incompatible with local customs (APR 0.41, 95% CI: 0.18-0.94); or (3) reduces sexual satisfaction (APR 0.10, 95% CI: 0.02-0.62) were inversely associated with future VMMC intent. Demand-creation efforts must confront salient cognitive and social barriers to VMMC uptake, including concerns around incompatibility with local customs. Simultaneously, promotional efforts should emphasise relevant VMMC benefits beyond HIV prevention that resonate with men (e.g. penile hygiene) without reinforcing harmful gender norms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Circuncisión Masculina Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male Idioma: En Revista: Afr J AIDS Res Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Sudáfrica
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Circuncisión Masculina Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male Idioma: En Revista: Afr J AIDS Res Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Sudáfrica