Muhamadi Lubega, Ibrahim Musenze, Wabwire-Mangen Fred, Peterson Stefan, Reynolds Steven J
District Health Office, Iganga District Administration, PO Box 358, Iganga, Uganda ; Division of Global Health, IHCAR, Department of Public Health Sciences, Karolinsika Institutet, Stockholm, Sweden ; Department of Epidemiology and Biostatistics, Makerere University School of Public Health, PO Box 7072, Kampala, Uganda ; School of Graduate Studies and Research Busoga University, PO BOX 154, Iganga Uganda.
Pan Afr Med J. 2013 Aug 5;15:117. doi: 10.11604/pamj.2013.15.117.2540. eCollection 2013.
Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings.
In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC.
Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service.
Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC.
尽管伊甘加区的自愿男性医学包皮环切术（VMMC）于2010年启动，作为乌干达国家预防新的艾滋病毒感染战略的一部分，目标是到2012年让129,896名符合条件的男性接受包皮环切术，但到2012年年中，仅完成了预期目标的35,000例（27%）。在这个据推测艾滋病毒知晓率较高的地区，关于VMMC接受率低的原因信息匮乏。本研究旨在从服务对象自身的角度了解接受VMMC的动机，以便倡导在伊甘加区及类似地区扩大VMMC接受率的可行方法。
在伊甘加区，我们对VMMC诊所的工作人员进行了7次关键 informant访谈，并对接受并完成VMMC的服务对象进行了20次深入访谈。还与接受过VMMC的服务对象进行了10次焦点小组讨论，共有112名参与者。
接受包皮环切术的服务对象和医护人员认为接受VMMC的动机包括：对接受包皮环切术者的医疗益处，如预防感染艾滋病毒和其他性传播疾病、同伴/伴侣影响、性满意度和安全性以及获得服务的成本。
由于感知到的医疗益处是寻求VMMC的一个动机，它可用于加强提高VMMC接受率的宣传活动。同伴影响也可用于VMMC扩大的宣传活动，特别是利用已经接受过VMMC的同伴。有必要确保获得服务的安全性和成本是可承受的，特别是对农村贫困人口而言，因为这被提及是寻求VMMC的一个动机。
