Voluntary Medical Male Circumcision (VMMC) is proven to reduce transmission of HIV/AIDS. Despite concerted efforts to scale up VMMC in men aged 18–49, the number of medically circumcised men in thi...

https://journals.sagepub.com/doi/pdf/10.1177/1557988319892437

Zulu Men's Conceptions, Understanding, and Experiences of Voluntary Medical Male Circumcision in KwaZulu-Natal, South Africa.

In countries such as Eswatini, where there is a high HIV prevalence and low male circumcision the World Health Organization and the Joint United Nations Programme for HIV/AIDS recommend infant and adult circumcision be implemented. The aim of this study was to assess the knowledge, attitudes and acceptability of voluntary medical male circumcision amongst males attending high school in Eswatini.An observational cross-sectional study was conducted during February and March of 2018 amongst 407 young males (15-21 years) attending Form 4, in nine high schools in the Shiselweni region of Eswatini using a self-administered questionnaire of 42 close ended questions. Sociodemographic details, circumcision status, acceptance of voluntary medical male circumcision, knowledge and attitude scores analysed in Stata® 14 statistical software were described using frequencies, medians and ranges respectively. Bivariate and multivariate linear regression was used to assess the impact of independent variables on circumcision status and acceptance of voluntary medical male circumcision. The level of statistical significance was p < 0.05.Amongst the 407 high school-going males, 48.98% (n = 201) reported being circumcised. The majority of the adolescents (75.74%; n = 306) were knowledgeable about voluntary medical male circumcision. However, an even larger majority (84.90% (n = 343) had a negative attitude towards it. In the multivariate logistic regression analysis, having parented their own children (aOR: 3.55; 95%CI: 1.2-10.48), and having circumcised friends (aOR: 3.99; 95%CI: 1.81-8.84) were significantly associated with being circumcised. Neither knowledge nor attitude were associated with the acceptability of voluntary medical male circumcision.In Eswatini male high school students are knowledgeable about voluntary medical male circumcision but have a negative attitude towards it. Having parented their own children, and having circumcised friends influenced being circumcised. 

/pdf/knowledge-attitudes-and-acceptance-of-voluntary-medical-male-20z9nnp0.pdf

Knowledge, attitudes and acceptance of voluntary medical male circumcision among males attending high school in Shiselweni region, Eswatini: a cross sectional study

Abstract Background In countries such as Eswatini, where there is a high HIV prevalence and low male circumcision the World Health Organization and the Joint United Nations Programme for HIV/AIDS recommend infant and adult circumcision be implemented. The aim of this study was to assess the knowledge, attitudes and acceptability of voluntary medical male circumcision amongst males attending high school in Eswatini. Methods An observational cross-sectional study was conducted during February and March of 2018 amongst 407 young males (15-21 years) attending Form 4, in nine high schools in the Shiselweni region of Eswatini using a self-administered questionnaire of 42 close ended questions. Sociodemographic details, circumcision status, acceptance of voluntary medical male circumcision, knowledge and attitude scores analysed in Stata® 14 statistical software were described using frequencies, medians and ranges respectively. Bivariate and multivariate linear regression was used to assess the impact of independent variables on circumcision status and acceptance of voluntary medical male circumcision. The level of statistical significance was p&lt;0.05 Results Amongst the 407 high school-going males, 48.98% (n= 201) reported being circumcised. The majority of the adolescents (75.74%; n= 306) were knowledgeable about voluntary medical male circumcision. However, an even larger majority (84.90% (n= 343) had a negative attitude towards it. In the multivariable logistic regression analysis, having parented their own children (OR: 3.55; 95%CI: 1.2 – 10.48), and having circumcised friends (OR: 3.99; 95%CI: 1.81 -8.84) were significantly associated with being circumcised. Neither knowledge nor attitude were associated with the acceptability of voluntary medical male circumcision. Conclusion In Eswatini male high school students are knowledgeable about voluntary medical male circumcision, but have a negative attitude towards it. Having parented their own children, and having circumcised friends influenced being circumcised. 

Zimbabwe is one of the 14 countries in eastern and southern Africa that have adopted Voluntary Medical Male Circumcision ( VMMC) as an HIV prevention intervention in response to WHO9s recommendation for countries with generalized high HIV epidemics and low VMMC prevalence. However, since 2013 when VMMC was scaled up in Zimbabwe, there was a general low uptake of the VMMC programme particularly on the target age group 20-29 years which has an immediate reduction in the HIV burden. The failure of VMMC uptake in the priority age group prompted the need to analyse the effectiveness of demand creation promotions and personnel used in creating demand for VMMC in Chitungwiza district, Zimbabwe. We employed judgmental sampling, a non-probability sampling technique where we interviewed VMMC clients (n=50) and service providers (n=10) using self administered questions, and community mobilizers (n=10) and demand creation teams (n=3) using face-to-face interviews based on their experience, knowledge and professional judgment. We also randomly analysed client records in the form of 50 Client Intake Forms (CIF) books. We found out that Community mobilizers and Demand creation officers were effective in mobilizing clients in the age group 10-15 years and 16-30 years respectively. The use of clinicians (nurses) was also found to be useful in creating demand for VMMC. We also found out that intensifying campaigns during school holidays, the use of tent-based/caravan campaigns and the door to door campaigns were most effective strategies under demand creation promotions. We concluded that there is need to increase demand creation officers and qualified community mobilizers. To regularly train and motivate current community mobilizers as well as increasing the use of clinicians(nurses) in demand creation . We recommended the need to increase the number of mobile caravans and intensifying on the door to door campaigns in the district.

https://biorxiv.org/content/biorxiv/early/2018/05/25/331397.full-text.pdf

Effectiveness of Demand creation promotions and demand creation personnel in creating demand for Voluntary Medical Male Circumcision, Chitungwiza District, Zimbabwe in 2016

This research aimed to evaluate the knowledge, attitudes, and practices among mothers caring for children aged 6 months to 2 years regarding Complementary Feeding (CF). Conducted over a one-month period from October to November 2020, this descriptive cross-sectional study engaged 206 Mothers/caretakers attending Ishaka Adventist Hospital OPD for various child health concerns, including immunization and growth monitoring. Participants were selected randomly based on their arrival order at the hospital during the study period. Data collection involved researcher-administered questionnaires for illiterate participants and self-administered questionnaires for literate individuals after obtaining consent. Participants' comprehension and execution of complementary feeding practices were assessed through their responses. Data entry and analysis utilized EPI-DATA and STATA 17 software. Univariate analysis determined frequency, mean, mode, and percentage of participant responses, while bivariate analysis explored the relationship between knowledge and attitude, and between knowledge and practices among mothers/caretakers at Ishaka Adventist Hospital's pediatric OPD. Findings revealed that only 4% of participants were knowledgeable about the frequency of both Complementary Feeding (CF) and Breastfeeding (BF) for infants and the ideal diet composition. However, 63% were aware of the appropriate ages to initiate CF and stop BF, along with the consequences of delayed CF initiation. Although 85.5% commenced CF at the recommended age of six months, merely 4.3% provided adequate quantity and quality of complementary feeds to their infants. The study discovered statistically significant associations between proper/poor CF practices and respondents' age, education level, socio-economic status, and number of children in the household. Despite varied practices, participants generally exhibited positive and supportive attitudes toward CF. Keywords: Breast milk, Malnutrition, Immunization, Complementary Feeding, Babies.

Understanding the Knowledge, Attitudes, and Practices of Mothers/Caretakers Regarding Complementary Feeding in Children Aged 6 Months to 2 Years Attending the Pediatrics Outpatient Department at Ishaka Adventist Hospital

Background : Voluntary Medical Male Circumcision (VMMC) is the surgical removal of all or part of the foreskin from the penis. It is done for medical reasons as it has been shown to reduce the risk of female to male transmission of HIV by up to 60%. It has also been associated with lower transmission of sexually transmitted infections. Voluntary Medical Male Circumcision services have been scaled up in countries with high prevalence, generalised heterosexual HIV epidemics and low rates of male circumcision. Kibera is inhabited by a multi-ethnic community with a sizeable number of un-circumcising ethnic groups. Objectives: To determine the uptake of voluntary medical male circumcision among men in Kibera Division and to identify factors associated with circumcision preference. Design: Descriptive cross-sectional study. Setting: Kibera Division of Nairobi County. Subjects : Simple random sampling was used to enrol 387 participants. A 42-item questionnaire was administered to the participants for determining the uptake of VMMC. It had three sub-sections: demographic characteristics, general knowledge about VMMC and AIDS and acceptability of VMMC, which collected data on the main outcome measures. Data captured was entered into EpiInfo and converted to Stata13 for validation and analysis. Bivariate statistics were generated for all the variables in accordance to the study questions. Categorical variables were analysed using chi-square tests, while the qualitative variables were analysed using the t-test. Multivariate logistic regression analysis was performed to identify factors associated with the acceptability of male circumcision. Results : The study analysed data for a sample of 341 individuals whose mean age was 31 years (95%= 31+-9.1) and 62% were married. A total of 54% of the respondents had completed secondary and tertiary level of education. The level of understanding about VMMC was above average. Fifty nine percent of the respondents (95% CI = 0.54 - 0.64) knew about VMMC. Of these, 31% had obtained information about VMMC from TV and radio. The most frequently mentioned reason for undergoing VMMC was prevention of HIV and sexually transmitted infections. The level of uptake of VMMC was high at 75%. The study established that the prefered age group for circumcision was during adolescence. Using multivariate logistic regression, the factors associated with uptake of VMMC were education level, medical and hygiene reasons for VMMC. Barriers for uptake were cost, pain and long recovery period after the operation. Conclusion: The uptake and acceptability of male circumcision is high among the general population in Kibera. Participant understanding of HIV and VMMC was also high. There is need for heightened awareness creation in educational institutes. This will specifically target young men before or shortly after their sexual debut when they may still be free of HIV and HSV-2 infections. Circumcision by medical providers should be increased in traditionally circumcising regions to reduce incidence of adverse events.

/pdf/factors-influencing-voluntary-medical-male-circumcision-58pb1i73wd.pdf

Factors influencing voluntary medical male circumcision among men aged 18-50 years in Kibera Division

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Factors influencing voluntary medical male circumcision among men aged 18-50 years in Kibera Division