Kateule Ernest, Kumar Ramya, Mwakazanga David, Mulenga Modest, Daka Victor, Chongwe Gershom
Zambia Field Epidemiology Training Program, Ministry of Health, Lusaka, Zambia.
Tropical Diseases Research Centre, Ndola, Zambia.
South Afr J HIV Med. 2019 Jun 20;20(1):952. doi: 10.4102/sajhivmed.v20i1.952. eCollection 2019.
New cases of HIV are increasing among young adults in Zambia; yet voluntary medical male circumcision (VMMC) coverage as an HIV prevention measure remains low. Despite having the highest HIV burden in the province, Ndola district had a VMMC coverage of 23% in 2015 compared to the national target of 80% among high-risk groups.
To determine predictive factors associated with circumcision status among male students in Ndola district.
We conducted a cross-sectional study in May 2016 among students aged 18-35 years enrolled in five conveniently sampled colleges. We administered a structured questionnaire to assess the knowledge, attitudes and perceptions about VMMC. We used multivariable logistic regression to determine factors associated with male circumcision (MC) status.
Of 136 students interviewed, 63% were circumcised, and of those, 96% were medically circumcised. Half of all students were aged 21-24 years. Those who perceived the circumcision procedure to be 'safe' (adjusted odds ratio [aOR] = 5.13; 95% CI: 2.09-14.82), and knew that it reduced female to male HIV transmission risk (aOR = 3.65; 95% CI: 3.12-11.67), were more likely to be circumcised. The perception that MC promotes 'promiscuous behaviour' (aOR = 0.20; 95% CI: 0.07-0.61), and that sexual sensitivity is the 'same' regardless of circumcision status, were associated with not being circumcised (aOR = 0.13; 95% CI: 0.02-0.80).
Students had adequate knowledge about the safety of medical circumcision, and the subsequent risk reduction of HIV infection. Interventions aimed at addressing negative sexual perceptions about circumcision may increase VMMC coverage among college students.
赞比亚年轻成年人中的新增艾滋病病毒（HIV）病例不断增加；然而，作为一种HIV预防措施的自愿男性包皮环切术（VMMC）覆盖率仍然很低。尽管恩多拉区是该省HIV负担最重的地区，但2015年其VMMC覆盖率为23%，而高危人群的国家目标覆盖率为80%。
确定恩多拉区男学生中与包皮环切术状况相关的预测因素。
2016年5月，我们在五所方便抽样的学院中对18至35岁的学生进行了一项横断面研究。我们发放了一份结构化问卷，以评估对VMMC的知识、态度和看法。我们使用多变量逻辑回归来确定与男性包皮环切术（MC）状况相关的因素。
在接受访谈的136名学生中，63%进行了包皮环切术，其中96%是通过医学方式进行的包皮环切术。所有学生中有一半年龄在21至24岁之间。那些认为包皮环切手术“安全”的人（调整后的优势比[aOR]=5.？13；95%置信区间：2.09 - 14.82），以及知道该手术可降低女性向男性传播HIV风险的人（aOR = 3.65；95%置信区间：3.12 - 11.67），更有可能接受包皮环切术。认为MC会促进“滥交行为”的看法（aOR = 0.20；95%置信区间：0.07 - 0.61），以及认为无论包皮环切术状况如何，性敏感度“相同”的看法，与未接受包皮环切术相关（aOR = 0.13；95%置信区间：0.02 - 0.80）。
学生们对医学包皮环切术的安全性以及随后降低HIV感染风险有足够的了解。旨在解决对包皮环切术的负面性观念的干预措施可能会提高大学生中的VMMC覆盖率。
