Attitudes, beliefs and intentions around neonatal male circumcision (MC)
as an HIV prevention intervention: results from a representative sample of
K. Hatzold1, W. Mavhu2, R. Buzdugan3, L. Langhaug3, C. Benedict4, J. Sherman5, S. Laver5, G. Woelk2, F. Cowan3,6
1PSI Zimbabwe, Harare, Zimbabwe, 2University of Zimbabwe, Community Medicine, Harare, Zimbabwe, 3University College London, Centre for Sexual Health & HIV Research, London, United Kingdom, 4UNFPA Zimbabwe, Harare, Zimbabwe, 5UNICEF Zimbabwe, Harare, Zimbabwe, 6University of Zimbabwe, Community Medicine, Harare, Zimbabwe
Background: Neonatal MC carries the same HIV prevention and other health
benefits as adult MC but is done before the individual becomes sexually
active. Neonatal MC is easier, quicker
and safer than adult MC and can be done by health care cadres other than
doctors. The objective was to assess attitudes and intentions related to
neonatal circumcision among rural Zimbabweans.
Methods: A representative survey was conducted in six districts in two rural provinces.
The survey was to evaluate Zimbabwe's National Behaviour Change Programme. All
18-24 year olds and one in three 25-44 year olds living in selected enumeration
areas were invited to participate. Participants
completed a questionnaire. Logistic regression was used
to predict willingness to have son circumcised if it prevented HIV.
Results: 2,746 adults (64% females) participated (87% of eligibles). 60% said
that they would have their son circumcised if MC was effective in preventing HIV.
Among those who would not, 39% did not believe it was effective, 19% said it
was not culturally/religiously acceptable and 13% said their son should decide
when older. 12% had high levels of MC knowledge (6/8
correct responses), 32% medium (3-5/8 correct) and 57% low levels (1-2/8
correct). 86% of men and 79% of women with high knowledge were willing to have
their sons circumcised compared to 47% and 57% of those with low knowledge. Predictors of willingness to
have son circumcised among men were MC knowledge (adjusted OR
1.32;95%CI:1.22-1.44) and being HIV positive (AOR 2.00;95%CI:1.08-3.69). Among
women, predictors were MC knowledge (AOR 1.11;95% CI:0.99-1.25), HIV knowledge
(AOR 1.10;95% CI:1.02-1.19 and being HIV negative (AOR 1.16;95% CI:1.00-1.35).
of circumcision was sub-optimal. The majority thought neonatal circumcision was
acceptable. Knowledge of MC and HIV plus knowing one's HIV status were
predictors of willingness to circumcise. These findings will be used to plan
neonatal MC services.
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