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Shifting reasons for older men remaining uncircumcised: Findings from a pre- and post-demand creation intervention among men aged 25-39 years in western Kenya.

作者信息

Agot Kawango, Onyango Jacob, Otieno George, Musingila Paul, Gachau Susan, Ochillo Marylyn, Grund Jonathan, Joseph Rachael, Mboya Edward, Ohaga Spala, Omondi Dickens, Odoyo-June Elijah

机构信息

Impact Research and Development Organization, Kisumu, Kenya.

Center for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.

出版信息

PLOS Glob Public Health. 2024 May 31;4(5):e0003188. doi: 10.1371/journal.pgph.0003188. eCollection 2024.


DOI:10.1371/journal.pgph.0003188
PMID:38820408
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11142559/
Abstract

Voluntary medical male circumcision (VMMC) reduces men's risk of acquiring Human immunodeficiency virus (HIV) through vaginal sex. However, VMMC uptake remains lowest among Kenyan men ages 25-39 years among whom the impact on reducing population-level HIV incidence was estimated to be greatest at the start of the study in 2014. We conducted a pre- and post-intervention survey as part of a cluster randomized controlled trial to determine the effect of two interventions (interpersonal communication (IPC) and dedicated service outlets (DSO), delivered individually or together) on improving VMMC uptake among men ages 25-39 years in western Kenya between 2014 and 2016. The study had three intervention arms and a control arm. In arm one, an IPC toolkit was used to address barriers to VMMC. In arm two, men were referred to DSO that were modified to address their preferences. Arm three combined the IPC and DSO. The control arm had standard of care. At baseline, uncircumcised men ranked the top three reasons for remaining uncircumcised. An IPC demand creation toolkit was used to address the identified barriers and men were referred for VMMC at study-designated facilities. At follow-up, those who remained uncircumcised were again asked to rank the top three reasons for not getting circumcised. There was inconsistency in ranking of reported barriers at pre- and post- intervention: 'time/venue not convenient' was ranked third at baseline and seventh at follow-up; 'too busy to go for circumcision' was tenth at baseline but second at follow-up, and concern about 'what I/family will eat' was ranked first at both baseline and follow-up, but the proportion reduced from 62% to 28%. Men ages 25-39 years cited a variety of logistical and psychosocial barriers to receiving VMMC. After exposure to IPC, most of these barriers shifted while some remained the same. Additional innovative interventions to address on-going and shifting barriers may help improve VMMC uptake among older men.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31f3/11142559/9319c0d5c762/pgph.0003188.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31f3/11142559/9319c0d5c762/pgph.0003188.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31f3/11142559/9319c0d5c762/pgph.0003188.g001.jpg

相似文献

[1]
Shifting reasons for older men remaining uncircumcised: Findings from a pre- and post-demand creation intervention among men aged 25-39 years in western Kenya.

PLOS Glob Public Health. 2024-5-31

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia.

S Afr Fam Pract (2004). 2023-5-10

[2]
Exploring culturally-preferred communication approaches for increased uptake of voluntary medical male circumcision (VMMC) services in rural Malawi.

BMC Public Health. 2023-3-29

[3]
Voluntary Medical Male Circumcisions for HIV Prevention - 13 Countries in Eastern and Southern Africa, 2017-2021.

MMWR Morb Mortal Wkly Rep. 2023-3-10

[4]
Strategies to increase uptake of voluntary medical male circumcision among men aged 25-39 years in Nyanza Region, Kenya: Results from a cluster randomized controlled trial (the TASCO study).

PLoS One. 2023

[5]
Cost-effectiveness of voluntary medical male circumcision for HIV prevention across sub-Saharan Africa: results from five independent models.

Lancet Glob Health. 2023-2

[6]
Understanding the Evolving Role of Voluntary Medical Male Circumcision as a Public Health Strategy in Eastern and Southern Africa: Opportunities and Challenges.

Curr HIV/AIDS Rep. 2022-12

[7]
Factors Influencing the Uptake of Voluntary Medical Male Circumcision Among Boda-Boda Riders Aged 18-49 Years in Hoima, Western Uganda.

HIV AIDS (Auckl). 2022-9-23

[8]
The case for prevention - Primary HIV prevention in the era of universal test and treat: A mathematical modeling study.

EClinicalMedicine. 2022-3-14

[9]
Key challenges to voluntary medical male circumcision uptake in traditionally circumcising settings of Machinga district in Malawi.

BMC Public Health. 2021-10-28

[10]
Innovative demand creation strategies to increase voluntary medical male circumcision uptake: a pragmatic randomised controlled trial in Zimbabwe.

BMJ Glob Health. 2021-7

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