Knowledge on voluntary medical male circumcision in a low uptake setting in northern Uganda

Abstract

BackgroundFree VMMC services have been available in Uganda since 2010. However, uptake in Northern Uganda remains disproportionately low. We aimed to determine if this is due to men’s insufficient knowledge on VMMC, and if women’s knowledge on VMMC has any association with VMMC status of their male sexual partners.MethodsIn this cross sectional study, participants were asked their circumcision status (or that of their male sexual partner for female respondents) and presented with 14 questions on VMMC benefits, procedure, risk, and misconceptions. Chi square tests or fisher exact tests were used to compare circumcision prevalence among those who gave correct responses versus those who failed to and if p < 0.05, the comparison groups were balanced with propensity score weights in modified poisson models to estimate prevalence ratios, PR.ResultsA total of 396 men and 50 women were included in the analyses. Circumcision was 42% less prevalent among males who failed to reject the misconception that VMMC reduces sexual performance (PR = 0.58, 95% CI 0.38–0.89, p = 0.012), and less prevalent among male sexual partners of females who failed to reject the same misconception (PR = 0.22, 95% CI = 0.07–0.76, p = 0.016). Circumcision was also 35% less prevalent among male respondents who failed to reject the misconception that VMMC increases a man’s desire for more sexual partners i.e. promiscuity (PR = 0.65, 95% CI = 0.46–0.92, p = 0.014).ConclusionMisconceptions regarding change in sexual drive or performance were associated with circumcision status in this population, while knowledge of VMMC benefits, risks and procedure was not.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6158-2) contains supplementary material, which is available to authorized users.

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

“…This study was a sub-study of a research that was looking at the correlates of VMMC uptake in northern Uganda. Two other papers that looked at knowledge, enhancers and barriers of VMMC uptake in this region have already been published 11 , 12 . After answering that question, the study further wanted to know why the people in Gulu especially men did not seek VMMC services which were being offered at no cost both at static and mobile (out - reaches or camps) sites within their communities.…”

“…The questions were administered in a respondent's preferred language. The questions analyzed for this manuscript were about perception of increased risk of HIV infection though the other questions were mainly about knowledge of VMMC messages and has already been published 11 . Systematic sampling was used to select households using lists that had been used earlier during a mosquito net distribution campaign.…”

“…HIV testing services (HTS) are not treatment but a precursor to adopting to HIV prevention methods. ABCs have not been effective in reducing the spread of HIV infection, their cumulative effect has diminished spread in some instances and modified behavior in other instances 7,8,9 Voluntary Medical Male Circumcision is by far the most efficient and effective biomedical intervention in reducing the HIV epidemic since it a one-off procedure 10 . For the past 6 years, Uganda has been scaling up VMMC services in the entire country.…”

Perceived Risk and Severity of the Uptake of Safe Male Circumcision Services among Young Men Aged 15-24 Years in Rhino Camp Refugees Settlement, Arua District- Uganda

“…Also, perceived severity such as bleeding and infection, irritation of the glans, injury to the penis and increased Meatitis made uptake of safe male circumcision services low [9]. Uganda's scenario of uptake of safe male circumcision is not far different from other countries in the region, up take is still low despite being free [10]. The country's target by 2015 was to circumcise 4.2 million adults, however, required an effective model to achieve [3].…”

Zulu Men’s Conceptions, Understanding, and Experiences of Voluntary Medical Male Circumcision in KwaZulu-Natal, South Africa

“…Research done on the uptake of VMMC amongst males has shown that several barriers and drivers hinder and influence the uptake of VMMC by males (Hankins et al, 2016; Nanteza et al, 2018; Rodriguez et al, 2019). Among these are: (1) individuals’ perceptual factors related to fear of pain, procedural complications, and fear of the HIV testing; (2) social factors such as norms, values, and cultural and religious beliefs; (3) social influences such as female partner roles, the media and other public figures, and role models (Abunah et al, 2016; Jones et al, 2018; Nanteza et al, 2018; Osaki et al, 2015; Rodriguez et al, 2019; Wambura et al, 2017).…”