Rupfutse Maxwell, Tshuma Cremence, Tshimanga Mufuta, Gombe Notion, Bangure Donewell, Wellington Maureen
Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe.
Ministry of Health and Child Care Mashonaland Central Province Medical Directorate, Zimbabwe.
Pan Afr Med J. 2014 Nov 28;19:337. doi: 10.11604/pamj.2014.19.337.5245. eCollection 2014.
Voluntary Medical Male Circumcision (VMMC) is the surgical removal of the foreskin by a trained health worker. VMMC was introduced in Zimbabwe in 2009. It is of concern that the programme performance has been below expectations nationally and in Mazowe district. Zimbabwe is unlikely to meet its 2015 target of circumcising 1 200 000 men aged between 15 and 29 years and unlikely to enjoy maximum benefits of VMMC which include prevention of HIV, sexually transmitted infections and cervical cancer. We therefore broadly aimed at identifying factors influencing the level of VMMC uptake in Mazowe district.
An analytic cross-sectional study was carried out in Mazowe district. A multi-stage probability sampling strategy was used to select 300 men aged between 18 and 49 years. Pretested interviewer administered questionnaires, key informant interviews and focus group discussions were used to collect data. Quantitative data was analysed using Epi info where odds ratios and p-values were calculated. Qualitative data was analysed thematically.
Being of Shona origin (AOR= 7.69 (95%CI 1.78-33.20)), fear of pain (AOR= 7.09 (95%CI 2.58-19.47)) and fear of poor wound healing (AOR= 2.68 (95%CI 1.01-7.08)) were independently associated with being uncircumcised while having a circumcised friend and encouragement by a friend or relative were independently associated with being circumcised.
Fear of pain, fear of poor wound healing and encouragement by a friend or relative were associated with circumcision status. Widening use of surgical devices and third part referrals may assist in scaling up the programme.
自愿男性包皮环切术（VMMC）是由经过培训的卫生工作者进行的包皮切除手术。VMMC于2009年在津巴布韦推行。令人担忧的是，该项目在全国以及马佐韦区的实施情况未达预期。津巴布韦不太可能实现其在2015年为120万名年龄在15至29岁之间的男性进行包皮环切的目标，也不太可能充分享受到VMMC带来的最大益处，这些益处包括预防艾滋病毒、性传播感染和宫颈癌。因此，我们的总体目标是确定影响马佐韦区VMMC接受程度的因素。
在马佐韦区开展了一项分析性横断面研究。采用多阶段概率抽样策略选取了300名年龄在18至49岁之间的男性。通过经过预测试的访谈者发放问卷、关键信息人访谈和焦点小组讨论来收集数据。定量数据使用Epi info进行分析，计算比值比和p值。定性数据进行主题分析。
绍纳族裔（比值比=7.69（95%置信区间1.78 - 33.20））、害怕疼痛（比值比=7.09（95%置信区间2.58 - 19.47））以及害怕伤口愈合不良（比值比=2.68（95%置信区间1.01 - 7.08））与未进行包皮环切独立相关，而有进行过包皮环切的朋友以及受到朋友或亲属的鼓励与进行包皮环切独立相关。
害怕疼痛、害怕伤口愈合不良以及朋友或亲属的鼓励与包皮环切状况相关。扩大手术器械的使用和第三方转诊可能有助于扩大该项目的规模。
