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Acceptability and feasibility of early infant male circumcision for HIV prevention in Malawi.

作者信息

Chilimampunga Charles, Lijenje Simeon, Sherman Judith, Nindi Kelvin, Mavhu Webster

机构信息

Chancellor College, University of Malawi, Zomba, Malawi.

Ministry of Health, Lilongwe, Malawi.

出版信息

PLoS One. 2017 Apr 17;12(4):e0175873. doi: 10.1371/journal.pone.0175873. eCollection 2017.


DOI:10.1371/journal.pone.0175873
PMID:28414783
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5393613/
Abstract

BACKGROUND: Voluntary medical male circumcision (VMMC) has been successfully implemented in 14 countries as an additional HIV prevention intervention. As VMMC programs mature in most countries, the focus is now on how to sustain the HIV prevention gains realised from VMMC. As part of preparations for the sustainability phase, countries are either piloting or preparing to pilot early infant male circumcision (EIMC). This qualitative study explored the acceptability and feasibility of EIMC in Malawi in order to inform pilot implementation. METHODS: In 2016, 23 focus group discussions were held across Malawi with participants from several ethnicities and religions/faiths. Additionally, 21 key informant interviews were held with traditional and religious leaders, traditional circumcisers (ngalibas), policy-makers, programme managers and health-care workers. Audio recordings were transcribed, translated into English (where necessary), and thematically coded using NVivo 10. RESULTS: Discussions highlighted the socio-cultural significance of MC in Malawi. Knowledge or experience of EIMC was poor although acceptability was high among most ethnic/religious groups and key informants. Participants identified EIMC's comparative HIV benefits although a few health-care workers expressed scepticism. All participants said EIMC should be offered within a clinical setting. In addition to fathers, maternal uncles and traditional leaders were deemed key decision-makers. Potential barriers to EIMC included concerns about procedure safety as well as cultural considerations. Key informants felt it was feasible to offer EIMC in Malawi. Participants' recommendations, including phased implementation, engagement of traditional leaders, use of external mobilisers and initially reaching out to influential parents, will be taken into account when designing a pilot EIMC program. CONCLUSIONS: EIMC is potentially an acceptable and feasible HIV prevention intervention for most ethnic/religious groups in Malawi if wide-ranging, culturally appropriate demand-creation activities are developed, piloted, evaluated and appropriately implemented.

摘要

相似文献

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Acceptability and feasibility of early infant male circumcision for HIV prevention in Malawi.

PLoS One. 2017-4-17

[2]
Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe.

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[6]
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引用本文的文献

[1]
Health worker perspectives on, and health system-level facilitators and barriers to early infant male circumcision for HIV prevention in a traditionally non-circumcising community, Northeastern Uganda: a cross-sectional qualitative study.

BMC Health Serv Res. 2025-8-18

[2]
Black Women's Perceptions Towards Infant and Child Male Circumcision.

Matern Child Health J. 2023-8

[3]
Zambian Parents' Perspectives on Early-Infant Versus Early-Adolescent Male Circumcision.

AIDS Behav. 2023-6

[4]
Uptake of voluntary medical male circumcision among men with sexually transmitted infections in Lilongwe, Malawi: a protocol for a pre-interventional and post-interventional study.

BMJ Open. 2022-1-18

[5]
Non-therapeutic male circumcision in infancy or childhood and risk of human immunodeficiency virus and other sexually transmitted infections: national cohort study in Denmark.

Eur J Epidemiol. 2022-3

[6]
Description of adverse events among adult men following voluntary medical male circumcision: Findings from a circumcision programme in two provinces of South Africa.

PLoS One. 2021

[7]
Changing Cultural Practices: A Case Study of Male Circumcision in South Africa.

Am J Mens Health. 2020

本文引用的文献

[1]
Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe.

BMC Int Health Hum Rights. 2017-1-9

[2]
Randomised trial of early infant circumcision performed by clinical officers and registered nurse midwives using the Mogen clamp in Rakai, Uganda.

BJU Int. 2017-1

[3]
Scaling Up and Sustaining Voluntary Medical Male Circumcision: Maintaining HIV Prevention Benefits.

Glob Health Sci Pract. 2016-7-13

[4]
Scale-Up of Early Infant Male Circumcision Services for HIV Prevention in Lesotho: A Review of Facilitating Factors and Challenges.

Glob Health Sci Pract. 2016-7-13

[5]
Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland.

Glob Health Sci Pract. 2016-7-13

[6]
Comparative Cost of Early Infant Male Circumcision by Nurse-Midwives and Doctors in Zimbabwe.

Glob Health Sci Pract. 2016-7-13

[7]
Perspectives of Parents and Health Care Workers on Early Infant Male Circumcision Conducted Using Devices: Qualitative Findings From Harare, Zimbabwe.

Glob Health Sci Pract. 2016-7-13

[8]
Safety, Acceptability, and Feasibility of Early Infant Male Circumcision Conducted by Nurse-Midwives Using the AccuCirc Device: Results of a Field Study in Zimbabwe.

Glob Health Sci Pract. 2016-7-13

[9]
Long-Term Investment for Infants: Keys to a Successful Early Infant Male Circumcision Program for HIV Prevention and Overall Child Health.

Glob Health Sci Pract. 2016-7-13

[10]
Bringing Early Infant Male Circumcision Information Home to the Family: Demographic Characteristics and Perspectives of Clients in a Pilot Project in Tanzania.

Glob Health Sci Pract. 2016-7-13

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