Department of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
Afr J Prim Health Care Fam Med. 2022 Oct 31;14(1):e1-e9. doi: 10.4102/phcfm.v14i1.3500.
The World Health Organization recommends medical male circumcision (MMC) to prevent human immunodeficiency virus (HIV). More research is needed in South Africa on factors influencing the uptake of MMC.
To evaluate factors associated with uptake of MMC.
Diepsloot, Johannesburg, South Africa.
An observational case-control study. Cases (men attending a private general practice (GP) offering free MMC) were compared to controls (uncircumcised men attending a local shopping mall) for a variety of demographic, sociocultural and financial factors. Factors were analysed using bivariate and multiple-variable binary forward logistic regression with the Statistical Package for Social Sciences.
There were 350 cases and 350 controls. Four factors were associated with the uptake of MMC: being a student (adjusted odds ratio [AOR]: 6.29, 95% confidence interval [CI]: 2.29-17.26), attending a mainline Christian denomination (AOR 2.85, 95% CI: 1.39-5.78), speaking an African language other than Zulu (range of AORs: 2.5-6.8, p 0.05) and being South African (AOR: 2.50, 95% CI: 1.58-3.96). MMC was associated with feeling susceptible to HIV, seeing it as a serious health problem and being encouraged by partners. Men who were sterilised, not sexually active and without symptoms of a sexually transmitted infection felt less susceptible. Other barriers included the pain of the procedure, indirect costs, anticipated impact on sexual activity, lack of information, cultural beliefs, embarrassment and access to health services.
世界卫生组织建议进行医学男性包皮环切术（MMC）以预防人体免疫缺陷病毒（HIV）。在南非，需要更多研究来了解影响 MMC 普及率的因素。
评估与 MMC 普及率相关的因素。
约翰内斯堡迪普斯鲁特，南非。
采用观察性病例对照研究。病例组（在提供免费 MMC 的私人全科医生就诊的男性）与对照组（在当地购物中心就诊的未割礼男性）在各种人口统计学、社会文化和经济因素方面进行比较。使用社会科学统计软件包进行双变量和多变量二元向前逻辑回归分析。
共有 350 例病例和 350 例对照。有四个因素与 MMC 的普及率相关：学生身份（调整后的优势比 [OR]：6.29，95%置信区间 [CI]：2.29-17.26）、参加主流基督教教派（OR 2.85，95%CI：1.39-5.78）、说祖鲁语以外的非洲语言（OR 范围为 2.5-6.8，p<0.05）和南非人（OR：2.50，95%CI：1.58-3.96）。MMC 与感觉易感染 HIV、将其视为严重健康问题以及伴侣的鼓励有关。已绝育、无性行为且无性传播感染症状的男性感觉不易受感染。其他障碍包括手术疼痛、间接费用、对性行为的预期影响、缺乏信息、文化信仰、尴尬和获得卫生服务的机会。
