Gilbert Hannah N, Wyatt Monique A, Asiimwe Stephen, Turyamureeba Bosco, Tumwesigye Elioda, Van Rooyen Heidi, Barnabas Ruanne V, Celum Connie L, Ware Norma C
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Harvard Global, Cambridge, MA, USA.
AIDS Res Treat. 2018 May 3;2018:8387436. doi: 10.1155/2018/8387436. eCollection 2018.
Voluntary medical male circumcision (MMC) reduces risk of HIV infection, but uptake remains suboptimal among certain age groups and locations in sub-Saharan Africa. We analysed qualitative data as part of the Linkages Study, a randomized controlled trial to evaluate community-based HIV testing and follow-up as interventions promoting linkage to HIV treatment and prevention in Uganda and South Africa. Fifty-two HIV-negative uncircumcised men participated in the qualitative study. They participated in semistructured individual interviews exploring (a) home HTC experience; (b) responses to test results; (c) efforts to access circumcision services; (d) outcomes of efforts; (e) experiences of follow-up support; and (f) local HIV education and support. Interviews were audio-recorded, translated, transcribed, and summarized into "linkage summaries." Summaries were analysed inductively to identify the following three thematic experiences shaping men's circumcision choices: (1) intense relief upon receipt of an unanticipated seronegative diagnosis, (2) the role of peer support in overcoming fear, and (3) anticipation of missed economic productivity. Increased attention to the timing of demand creation activities, to who delivers information about the HIV prevention benefits of MMC, and to the importance of missed income during recovery as a barrier to uptake promises to strengthen and sharpen future MMC demand creation strategies.
自愿男性医学包皮环切术（MMC）可降低感染艾滋病毒的风险，但在撒哈拉以南非洲的某些年龄组和地区，接受率仍不理想。我们分析了定性数据，这是“联系研究”的一部分，该研究是一项随机对照试验，旨在评估以社区为基础的艾滋病毒检测和随访，作为乌干达和南非促进与艾滋病毒治疗及预防相联系的干预措施。52名未接受包皮环切术的艾滋病毒阴性男性参与了定性研究。他们参与了半结构化的个人访谈，探讨了：（a）家庭艾滋病毒检测咨询服务（HTC）经历；（b）对检测结果的反应；（c）获取包皮环切服务的努力；（d）努力的结果；（e）随访支持的经历；以及（f）当地的艾滋病毒教育和支持。访谈进行了录音、翻译、转录，并总结为“联系摘要”。对摘要进行归纳分析，以确定影响男性包皮环切选择的以下三种主题经历：（1）收到意外的血清阴性诊断后如释重负；（2）同伴支持在克服恐惧方面的作用；（3）对错过经济生产力的预期。更加关注需求创造活动的时机、提供MMC预防艾滋病毒益处信息的人员，以及康复期间错过收入作为接受障碍的重要性，有望加强并完善未来的MMC需求创造策略。
