Lilleston Pamela S, Marcell Arik V, Nakyanjo Neema, Leonard Lori, Wawer Maria J
a Department of Health, Behavior, and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
b Department of Population, Family, and Reproductive Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
AIDS Care. 2017 Aug;29(8):1049-1055. doi: 10.1080/09540121.2016.1274014. Epub 2017 Mar 1.
Despite access to safe medical male circumcision (MMC) and proven effectiveness of the procedure in reducing acquisition of HIV and other sexually transmitted infections, uptake remains suboptimal in many settings in sub-Saharan Africa, including Rakai District, Uganda. This study explored multilevel barriers and facilitators to MMC in focus group discussions (FGDs) (n = 35 groups) in Rakai. Focus groups were conducted from May through July 2012 with adolescent and adult males, with a range of HIV risk and reproductive health service use profiles, and with adolescent and adult females. Data were analyzed using Atlas.ti and an inductive approach. Participants' discussions produced several key themes representing multilevel influences that may facilitate or create barriers to uptake of MMC. These include availability of MMC services, economic costs, masculine ideals, religion, and social influence. Understanding how males and females view MMC is a crucial step towards increasing uptake of the procedure and reducing disease transmission.
尽管可以获得安全的男性包皮环切术（MMC），且该手术在减少艾滋病毒及其他性传播感染的感染率方面已被证实有效，但在撒哈拉以南非洲的许多地区，包括乌干达的拉凯区，该手术的接受率仍不理想。本研究通过在拉凯区进行焦点小组讨论（FGDs）（n = 35个小组），探讨了MMC的多层次障碍和促进因素。焦点小组讨论于2012年5月至7月进行，参与者包括青少年和成年男性，他们具有不同的艾滋病毒风险和生殖健康服务使用情况，以及青少年和成年女性。使用Atlas.ti软件和归纳法对数据进行了分析。参与者的讨论产生了几个关键主题，代表了可能促进或阻碍MMC接受的多层次影响因素。这些因素包括MMC服务的可及性、经济成本、男性理想、宗教和社会影响。了解男性和女性对MMC的看法是提高该手术接受率和减少疾病传播的关键一步。
