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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Circumcision preference among women and uncircumcised men prior to scale-up of male circumcision for HIV prevention in Kisumu, Kenya
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 24, No. 2, Year 2012
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Description
Following the endorsement by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) of male circumcision as an additional strategy to HIV prevention, initiatives to introduce safe, voluntary medical male circumcision (VMMC) services commenced in 2008 in several sub-Saharan African communities. Information regarding perceptions of circumcision as a method of HIV prevention, however, is largely limited to data collected before this important endorsement and the associated increase in the availability of VMMC services. To address this, we completed a community-based survey of male circumcision (MC) perceptions in the major non-circumcising community in Kenya, which is the current focus of VMMC programs in the country. Data was collected between November 2008 and April 2009, immediately before VMMC program scale-up commenced. Here we present results limited to women (n = 1088) and uncircumcised males (n = 460) to provide insight into factors contributing to the acceptability and preference for MC in those targeted by VMMC programs. Separate multivariable models examining preference for circumcision were defined for married men, unmarried men, and women. Belief in the protective effect of circumcision on HIV risk was strongly associated with preference for MC in all models. Other important factors included education, perceived improvement in sexual pleasure, and perceptions of impact on condom utilization. Identified barriers to circumcision were the belief that circumcision was not part of the local culture, the perception of a long healing period following the procedure, the lack of a specific impetus to seek out services, and the general fear of pain associated with becoming circumcised. A minority of participants expressed beliefs suggesting that behavioral risk compensation with increased MC prevalence and awareness is a possibility. This work describes the early impact of a large-scale VMMC program on beliefs and behaviors regarding MC and HIV risk. It is hoped that our findings may offer guidance into anticipating potential impacts that similar programs may observe in populations throughout Eastern Africa. © 2012 Taylor and Francis Group, LLC.
Authors & Co-Authors
Westercamp, Matthew D.
Kenya, Kisumu
Nyanza Reproductive Health Society
United States, Chicago
University of Illinois at Chicago
Agot, Kawango E.
Kenya, Kisumu
Impact Research and Development Organization
Ndinya-Achola, Jeckoniah O.
Kenya, Nairobi
University of Nairobi
Bailey, Robert C.
United States, Chicago
University of Illinois at Chicago
Statistics
Citations: 80
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.1080/09540121.2011.597944
ISSN:
09540121
e-ISSN:
13600451
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Kenya
Participants Gender
Male
Female