Mp51-12 National Cancer Screening Disparities and Trends of African Americans Compared to Caucasian Americans From 2000-2015

Abstract

INTRODUCTION AND OBJECTIVES: Randomized controlled trials (RCTs) have demonstrated male circumcision (MC) to be protective for HIV infection. In 2016, WHO renewed its mission of 27 million circumcisions in sub-Saharan males aged 10-29 years old by 2021. The objective of this study was to identify patient motivators for undergoing MC to help guide future MC campaigns in Africa.METHODS: Males aged 10 years or greater, in good health were enrolled in a study examining no-flip ShangRing circumcision conducted at Homa Bay and Vipingo, Kenya were included in this study. Demographic factors, patient motivations, and presenting complaints related to their foreskin were evaluated in this analysis. Multivariate logistic regression analysis was performed using STATA 14 (StataCorp, College Station, TX).RESULTS: A total of 574 males underwent ShangRing MC from Homa Bay (n¼340) and Vipingo (n¼234). Among participants, the primary reason for MC was hygiene in 262 (46.3%); social or religious reasons in 146 (25.8%); HIV protection in 149 (26.3%); social stigma in 5 (0.8%); or as part of medical therapy, preventing cervical cancer, cracking of foreskin during intercourse, and for self-esteem in 1 (0.2%) each. On multivariate analysis, HIV prevention was a stronger predictor for MC among those with college education (OR 2.56, p¼0.01). Religion or social reasons were more common motivators for Muslim men (OR 5.36, p<0.001). Hygiene was the most common motivator for Christian men (p<0.001). Conditions related to the foreskin leading to MC included penile adhesions in 88 (15.3%), difficulty retracting foreskin in 46 (8%), difficulty protracting foreskin in 22 (3.8%), urethral discharge in 2 (0.3%), dysuria in 2 (0.3%), and scrotal swelling in 1 (0.2%).CONCLUSIONS: In this study, we determined that reasons for undergoing MC vary significantly depending upon religious beliefs, and level of education. Given the demographic diversity in sub-Saharan Africa, it is important to consider these factors when engaging men to consider MC.