Perceived influence of value systems on the uptake of voluntary medical male circumcision among men in Kweneng East, Botswana

Mavundla, Thandisizwe Redford; Mbengo, Fungai; Ngomi, Khanyenda Bruce

doi:10.1080/17290376.2020.1810748

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…Therefore, the observation made by the study in this regard could be that the majority of persons circumcised in that region are not circumcised under VMMC but rather under routine cultural or religious circumcisions [ 2 ]. Similar studies in Zimbabwe [ 24 ], Kenya [ 19 ] and Botswana [ 25 ] also found that cultural practices influenced VMMC practices with the acceptability of VMMC varying by culture. Therefore, although this study observed a lower prevalence of VMMC uptake in both the Eastern Region (where cultural circumcisions are commonly practised) and the Western Region (where there are no widespread cultural circumcisions), the explanation could be two-fold.…”

Section: Discussionsupporting

confidence: 60%

Missed opportunity: low uptake of VMMC among men attending the OPD of a public health facility offering free VMMC services in Uganda

2023

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Background Studies in various countries including Uganda and Kenya have shown a much lower incidence of the human immunodeficiency virus (HIV) among men that underwent voluntary medical male circumcision (VMMC) compared to uncircumcised men. Wakiso district, the district with the highest prevalence of HIV in Uganda (7%), has a very low estimated proportion of men who have undergone VMMC (30.5%). Within the district, various public health facilities provide free VMMC services. This study examined the prevalence and factors associated with the uptake of VMMC among men attending the outpatient department (OPD) of a public facility offering VMMC services. Methods We conducted a cross-sectional study between July to August 2021 using a sample of men attending the OPD at Kira Health Centre IV. We defined VMMC uptake as the removal of all or part of the foreskin of the penis by a trained healthcare professional. We determined factors independently associated with VMMC uptake using a modified Poisson regression analysis with robust standard errors at a 5% statistical significance level. Adjusted prevalence risk ratios (APRR) were reported as the measure of outcome. Results Overall, 389 participants were enrolled in the study. The mean age of the participants was 27.2 (standard deviation ± 9.02) years. The prevalence of VMMC uptake was 31.4% (95% Confidence Interval [CI] 26.8–36.2). In the adjusted analysis, the uptake of VMMC among men attending the OPD of Kira HC IV was less likely among married participants compared to unmarried participants (APRR 0.64, 95% CI 0.48–0.88), among participants from Western tribes (APRR 0.50, 95% CI 0.41–0.86) or Eastern tribes (APPR 0.31, 95% CI 0.13–0.72) compared to participants from the Central tribes and among participants who didn’t disclose their sexual partner number compared to those that had one or no sexual partner (APRR 0.62, 95% CI 0.40–0.97). On the other hand, the prevalence of uptake of VMMC was 7 times among participants who were aware of VMMC compared to those who were not aware of VMMC (APRR 7.85 95% CI 1.07–9.80) and 2.7 times among participants who knew their HIV status compared to those that didn’t know (APRR 2.75, 95% CI 1.85–4.0). Also, the uptake of VMMC was 85% more among participants who knew that Kira HC IV provided free VMMC services compared to those that didn’t (APRR 1.85, 95% CI 1.85–4.08). Conclusion VMMC among men attending the OPD at the largest public healthcare facility proving free VMMC services in Kira Municipality was low. The OPD may provide a quick win for improving VMMC uptake. Collaborative efforts among the administration of Kira HC IV, the Ministry of Health and VMMC implementation partners could work towards developing health-facility-based strategies that can improve VMMC awareness and uptake with emphasis on the OPD.

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Section: Discussionsupporting

confidence: 60%

Missed opportunity: low uptake of VMMC among men attending the OPD of a public health facility offering free VMMC services in Uganda

2023

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“…Evidence has shown that the success of a VMMC programme is greatly influenced by religious beliefs and cultural sentiments around: lack of openness between parents and children on sexual matters, traditional leadership, and consultation with stakeholders. [5] Such influences shape the uptake of the programme in different settings.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and perceptions of voluntary medical male circumcision among University of Juba students, South Sudan

Alier,

Cham,

Majok

et al. 2024

SSMJ

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Introduction: Voluntary medical male circumcision (VMMC) is one of the key interventions against heterosexual spread of HIV. However, its prevalence in South Sudan is not clearly understood. This study aimed to assess the prevalence and perceptions of VMMC among University of Juba students.Method: A cross sectional descriptive study design was adopted. Data from randomly selected students from six schools of the University of Juba were collected using a respondent-administered structured questionnaire. IBM SPSS Statistics version 23.0 was used for data analysis. Chi-squared tests were performed to determine variables significantly associated with VMMC.Results: Amongst 390 students interviewed, the prevalence of VMMC was 41.8% and the overall male circumcision rate was 83.8%. Most respondents expressed positive attitudes and perceptions towards VMMC. The respondents believe VMMC is an important health programme. The decision to get circumcised is associated with age, marital status, religion and state of origin (p<0.001).Conclusion: Most participants were circumcised and perceive VMMC positively. A countrywide study and scale up of the current VMMC programme are recommended.

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“…VMMC is culturally acceptable and there is high patient satisfaction in Botswana even though there is need for continuous involvement of influential community leaders [13][14][15]. As spontaneous public demand has not been sufficient to achieve VMMC coverage targets despite these facts, programs have come to rely on outreach activities designed to motivate potential clients to seek VMMC, termed demand creation activities.…”

Section: Introductionmentioning

confidence: 99%

Male circumcision uptake during the Botswana Combination Prevention Project

Marukutira¹,

Ussery

Kadima

et al. 2022

PLoS ONE

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Introduction Voluntary medical male circumcision (VMMC) uptake has been slow in some countries, including Botswana. To inform demand creation efforts, we examined sociodemographic characteristics and referral procedures associated with VMMC uptake in the Botswana Combination Prevention Project (BCPP) and examined the effectiveness of referral of men to MC services from HIV testing venues. Design BCPP was a community-randomized trial evaluating the impact of a combination HIV prevention package which included VMMC on community HIV incidence. We conducted a sub-analysis of VMMC uptake in intervention communities. Methods During the initial VMMC campaign in 15 intervention communities, baseline male circumcision (MC) status was assessed among men eligible for HIV testing. Uncircumcised male community residents aged 16–49 years with negative/unknown HIV status were mobilized and linked to study VMMC services. Outcomes included MC baseline status and uptake through study services. Univariate and multivariate logistic regressions were performed to identify factors associated with MC uptake. Results Of 12,864 men eligible for testing, 50% (n = 6,448) were already circumcised. Among the uncircumcised men (n = 6,416), 10% (n = 635) underwent MC. Of the 5,071 men identified as eligible for MC through HIV testing services, 78% declined referral and less than 1% of those were circumcised. Of those accepting referral (n = 1,107), 16% were circumcised. Younger (16–24 years) (aOR: 1.51; 95%CI:1.22,1.85), unemployed men (aOR:1.34; 95%CI: 1.06,1.69), and those undergoing HIV testing at mobile venues (aOR: 1.88; 95%CI: 1.53,2.31) were more likely to get circumcised. Fear of pain was the most prevalent (27%) reason given for not being circumcised. Conclusion Younger, unemployed men seeking HIV testing at mobile sites in Botswana were more likely to get VMMC. Addressing unique barriers for employed and older men may be necessary. Given the simplicity of VMMC as an intervention, the HIV testing programs offer a platform for identifying uncircumcised men and offering information and encouragement to access services.

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Perceived influence of value systems on the uptake of voluntary medical male circumcision among men in Kweneng East, Botswana

Cited by 9 publications

References 25 publications

Missed opportunity: low uptake of VMMC among men attending the OPD of a public health facility offering free VMMC services in Uganda

Missed opportunity: low uptake of VMMC among men attending the OPD of a public health facility offering free VMMC services in Uganda

Prevalence and perceptions of voluntary medical male circumcision among University of Juba students, South Sudan

Male circumcision uptake during the Botswana Combination Prevention Project

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