Predictors of Male Circumcision Among Men Aged 15–35 Years in Harare, Zimbabwe

Mangombe, Kudzaishe; Kalule-Sabiti, Ishumael

doi:10.1017/s0021932017000128

Cited by 8 publications

(10 citation statements)

References 21 publications

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“…However, there are some inconsistencies in the results. For instance, older age6 44 and younger age,12 45 and being employed46 or unemployed44 have been associated with increased VMMC uptake. Sociodemographic factors that have consistently predicted VMMC uptake include higher education (secondary school and above),10 12 46 belief of improved sexual performance10 12 47 and having two or more sexual partners or high self-perceived risk of HIV 12 14 45.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study

Matoga,

Kudowa,

Ndalama

et al. 2023

BMJ Open

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ObjectiveTo evaluate the effect a multistrategy demand-creation and linkage intervention on voluntary medical male circumcision (VMMC) uptake, time to VMMC and predictors of VMMC uptake among men with sexually transmitted infections (STIs).DesignPragmatic preinterventional and postinterventional quasi-experimental study combined with a prospective observational design.SettingA public and specialised STI clinic in Lilongwe, Malawi.PopulationUncircumcised men who presented to the STI clinic.Methods and interventionThe intervention consisted of transport reimbursement (‘R’), intensified health education (‘I’) and short-messaging services/telephonic tracing (‘Te’), abbreviated (RITe). A preintervention phase was conducted at baseline while RITe was rolled-out in the intervention phase in a sequential manner called implementation blocks: ‘I’ only—block 1; ‘I+Te’—block 2 and RITe—block 3.Main outcome measuresPrimary: VMMC uptake and time to VMMC for the full intervention and for each block. Secondary: predictors of VMMC uptake.ResultsA total of 2230 uncircumcised men presented to the STI clinic. The mean age was 29 years (SD±9), 58% were married/cohabiting, HIV prevalence was 6.4% and 43% had urethral discharge. Compared with standard of care (8/514, 1.6%), uptake increased by 100% during the intervention period (55/1716, 3.2%) (p=0.048). ‘I’ (25/731, 113%, p=0.044) and RITe (17/477, 125%, p=0.044) significantly increased VMMC uptake. The median time to VMMC was shorter during the intervention period (6 days, IQR: 0, 13) compared with standard of care (15 days, IQR: 9, 18). There was no significant incremental effect on VMMC uptake and time to VMMC between blocks. Men with genital warts were 18 times more likely to receive VMMC (adjusted relative risk=18.74, 95% CI: 2.041 to 172.453).ConclusionsOur intervention addressing barriers to VMMC improved VMMC uptake and time to VMMC among uncircumcised men with STIs, an important subpopulation for VMMC prioritisation.Trial registration numberNCT04677374.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study

Matoga,

Kudowa,

Ndalama

et al. 2023

BMJ Open

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“…Mozambique continues to face a generalized HIV epidemic, with an estimated prevalence of 10.1% among men 15-49 years in 2015 and 9.0% in 2021 [10,13]. Despite HIV prevention interventions over the past three decades, HIV and AIDS remain a significant public health challenge in Mozambique [4,11,[13][14][15].…”

Section: Traditional Circumcision Remains the More Common Form Of Cir...mentioning

confidence: 99%

“…Several randomized trials in Africa have provided evidence that MMC reduces the risk of female-to-male transmission of HIV by 60% [3]. Moreover, recent meta-analyses support the protective benefits of MMC in preventing HIV infection [4,5]. As a result, the World Health Organization (WHO) and the United Nations Programme on HIV/AIDS (UNAIDS) recommend that countries with generalized epidemics with low circumcision rates in the population introduce a strategy of providing MMC to uncircumcised men [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) identified 14 priority countries, including Mozambique, for MMC campaigns to reduce transmission of HIV. They set a target of 80% coverage for men aged 15-49 years [4,6,7] by 2018. The 2009 INSIDA, the last national HIV survey, found that 51% of males 15-49 years were circumcised.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between HIV/AIDS, Medical Male Circumcision and Traditional Circumcision in Mozambique, 2015

Militão,

Langa,

Braga

et al. 2023

Preprint

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BackgroundThe WHO AFRO region continues to be severely impacted by HIV and a global public health problem. In Mozambique, as of 2015, HIV prevalence was estimated to be 12.5% among adults. Medical male circumcision (MMC) has been promoted as a national prevention strategy to reduce the risk of HIV in men. We aimed to analyze the association between HIV infection, medical male circumcision and traditional male circumcision among men in Mozambique.MethodsCross-sectional data from the 2015 Mozambican National and Demographic Health Survey of Immunization, Malaria, and HIV/AIDS (IMASIDA) were used in this analysis. In this study, considered medical male circumcision (MMC) and medical circumcision (MC). Participants were asked about their circumcision status and where the circumcision was performed. In addition, blood samples were collected from participants and tested for HIV antibodies. All analyses were weighted and adjusted for the complex survey design to ensure results and approximate population parameters of interest. Chi-square tests and multiple logistic regression were used in the analyses to assess the associations between male circumcision and HIV infection.ResultsA total unweighted sample of 4733 men aged 15-49 consented to the survey and were interviewed. Of those who participated, 4236 consented to an HIV test. Nationally, 62.6% (95% CI 59.6-65.6) of men aged 15-49 years were circumcised. Traditional circumcision was the most common form of circumcision at 32.9% (95% CI 30.1-35.8), followed by MMC at 21.7% (95% CI 19.6-24.1), 8.0% (95% CI 6.5-9.9) did not know whether it was traditional or medical. The prevalence of HIV was highest at 13.4% among uncircumcised men (13.4%, 95% CI 11.3-15.7), and significantly lower among traditionally circumcised men (8.5%, 95% CI 6.8-10.6) and among medically circumcised men (7.5%, 95% CI 5.7-9.6). In multivariable analysis, men circumcised by a medical practitioner had almost 50% reduced odds of infection with HIV compared to uncircumcised men (aOR=0.52; 95% [CI=0.34-0.78], p=0.002), whereas men who were circumcised by traditional methods had a 29% reduced risk, but not significantly different than uncircumcised men (aOR=0.71; 95% [CI=0.47-1.07], p=0.098).ConclusionWe found that HIV prevalence was lower among men aged 15-49 years who were circumcised, and the odds of being HIV positive was about 50% lower among men who were circumcised by a medical practitioner, suggesting a reduced risk of HIV infection. Although Mozambique has not achieved the UNAIDS goal of 80% men circumcised at the time of the IMASIDA 2015 survey, we encourage the continued expansion of voluntary medical male circumcision.

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“…The dependent variable for this study was dichotomised; hence, a binary regression model (negative log-log) was used to analyse the factors associated under-five mortality. When the probability of a case is very low or very big, negative log-log models are frequently used (Mangombe andKalule-Sabiti 2018, McCullagh 1980). The adverse log-log feature is asymmetrical, unlike logit and probit models.…”

Section: Independent Variablesmentioning

confidence: 99%

Economy and Sociology 2020 No. 1

2020

Economy and Sociology

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The financial sector of the Republic of Moldova belongs to the developing ones and is characterized by a higher level of risk and, therefore, a higher likelihood of a systemic crisis. Globalization and development of advanced information technologies not only create great opportunities for rapid economic development, but also pose serious security threats to the economic development of states, especially in a developing economy. In these conditions, the issue of ensuring the financial stability of the state is becoming increasingly relevant. The state of the financial and foreign exchange market represents one of the most important aspects of the financial security of the state. This study has been developed as part of the scientific project 15.817.06.02A "Development of tools for measuring the financial stability of the state". The study analyzes various macrofinancial risk management tools. The purpose of this study was to calculate the pressure index on the foreign exchange market of both the Republic of Moldova and the main partner countries in terms of international trade. The results of related studies conducted by the authors of this work, which revealed that stability indicators in the foreign exchange market are associated with foreign trade risks served as an argument for the authors of the work to calculate the pressure index on the currency market of Romania and the Russian Federation for comparison with the indicators of the Republic of Moldova. Methods used in research include theoretical and comparative approaches, descriptive statistics and econometric models. The results of the research showed that international trade and the foreign exchange market are interdependent. The first can be considered a channel for transmitting the currency crisis, since demand increases with increasing imports, and this leads to increased pressure on the foreign exchange market. Increased exports reduce pressure on the foreign exchange market. But the greatest impact on the foreign exchange market in the Republic of Moldova is made by remittances from abroad, which are directly correlated with the dynamics of labor exports. At the same time, it was concluded that at present, due to macroprudential regulation, there are no linear dependencies in financial markets and, therefore, there are no correlations, but only the interdependence of variables.

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Predictors of Male Circumcision Among Men Aged 15–35 Years in Harare, Zimbabwe

Cited by 8 publications

References 21 publications

Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study

Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study

Association between HIV/AIDS, Medical Male Circumcision and Traditional Circumcision in Mozambique, 2015

Economy and Sociology 2020 No. 1

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