Determinants of Male Circumcision for HIV/AIDS Prevention in East Central Uganda

Brian Kironde, Robert Wamala, Betty Kwagala

Abstract

Safe Male Circumcision (SMC) is one the effective strategies for reducing HIV transmission. The paper examines factors associated with SMC for HIV prevention, based on 4,979 males from East Central Uganda. Data were analysed using chi-squared tests and multinomial logistic regression. Older males aged 31 years and above (p < 0.001), from predominantly non-circumcising districts (Buyende - p < 0.001, Kaliro p < 0.01, and Kamuli - p < 0.01); who had neither used condoms (p = 0.03) nor tested for HIV (p < 0.001) were less likely to circumcise for HIV prevention. Males who were assessed in 2012 (p < 0.001) three years after program implementation were more likely to circumcise for HIV for HIV prevention. Males that did not take measures to prevent HIV infection were less likely to undertake SMC and are therefore highly vulnerable to infection. These (together with older males, and males from non-circumcising districts) should be targeted for promotion of SMC alongside other HIV preventive measures. For better results, the benefits SMC for children as well as adults require emphasis. Wider coverage of SMC services should entail adequate equipping of public and where feasible, private facilities and appropriate training of health personnel countrywide. (Afr J Reprod Health 2016; 20[1]: 80-87).

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References

Joint United Nations Programme on HIV/AIDS (UNAIDS). Getting to Zero. HIV Factsheet. Geneva: UNAIDS; 2014. Retrieved from http:// www.unaid.org/en/resources/campaigns/2014/2014gapreport/factsheet. 2. UNAIDS. Report on the Global AIDS Epidemic. Geneva: UNAIDS; 2013. 3. Hladik F, Sakchalathorn P, Ballweber L, et al. Initial events in establishing vaginal entry and infection by human immunodeficiency virus type-1. Immunity 2007;26(2):257-70 4. Uganda Ministry of Health and ICF International. 2011

Kironde et al. Determinants of safe male circumcision for HIV prevention

African Journal of Reproductive Health March 2016; 20 (1): 87

Uganda AIDS Indicator Survey: Key Findings. Calverton, Maryland: MOH and ICF International, 2012. 5. UNAIDS. Male Circumcision. Geneva: UNAIDS; 2006.Retrieved from www.unaids.org/en /Policies /HIV Prevention/ Male_circumcision.aspN 6. The Lancet. Betting on HIV prevention. The Lancet 2006;368(9534):424. 7. WHO. Male Circumcision, global Trends and Determinants of Prevalence, Safety and Acceptability. Geneva: WHO/UNAIDS, 2007. 8. Uganda AIDS Commission. Annual performance review of the National HIV/AIDS Strategic Plan (2011/2012). Kampala UAC, 2011. 9. Gray R, Kigozi G, Kong X, et al. The effectiveness of male circumcision for HIV prevention and effects on risk behaviors in a post-trial follow up study in Rakai, Uganda. AIDS (London, England) 2012; 26(5):609. 10. Ouma EG. Factors influencing uptake of male circumcision among the Luo community in Nyando District, Kenya. University of Nairobi, Kenya, 2010. 11. Galukande M, Sekavuga DB, Duffy K, et al. Mass safe male circumcision: early lessons from a Ugandan urban site-a case study. The Pan African medical journal 2012;13. 12. Wilcken A, Keil T, Dick B. Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications. Bulletin of the World Health Organization 2010;88(12):907-14. 13. Bailey RC, Neema S, Othieno R. Sexual behaviors and other HIV risk factors in circumcised and uncircumcised men in Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes 1999;22(3):294-301. 14. STAR-EC. Strengthening Tuberculosis and HIV/AIDS Responses in East Central Uganda (STAR-EC). Program Year IV, Quarter III Progress Report: Strengthening TB and HIV/AIDS Response in East Central Uganda. Jinja, 2012. 15. De Vincenzi I, Mertens T. Male circumcision: a role in HIV prevention? AIDS 1994;8(2):153 16. Sarvestani AS, Bufumbo L, Geiger JD, et al. Traditional male circumcision in Uganda: a qualitative focus group discussion analysis. 2012. 17. Uganda Bureau of Statistics (UBOS). Uganda Population and Housing Census, Main Report. Entebbe, 2002. 18. UBOS and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS and Calverton, Maryland: ICF International Inc., 2012. 19. Rosenstock IM, Strecher VJ, Becker MH. The health belief model and HIV risk behavior change. Preventing AIDS: Springer, 1994:5-24. 20. Eaton L, Kalichman SC. Behavioral aspects of male circumcision for the prevention of HIV infection. Current HIV/AIDS Reports 2009;6(4):187-93. 21. Albert LM, Akol A, L'Engle K, et al. Acceptability of male circumcision for prevention of HIV infection among men and women in Uganda. AIDS care 2011;23(12):1578-85. 22. Ruan Y, Qian H-Z, Li D, et al. Willingness to be circumcised for preventing HIV among Chinese men who have sex with men. AIDS patient care and STDs 2009;23(5):315-21. 23. Westercamp N, Bailey R. Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: a review. AIDS and Behavior 2007;11(3):341-55. 24. Ministry of Health (MoH) and Family Health International (FHI). Situation analysis to determine the acceptability and feasibility of male Circumcision promotion in Uganda. Kampala: MoH/FHI; 2008. Retrieved from: http://www. malecircumcision.org/programs/documents/MC_situation_analysis_Uganda_full.pdf 25. UNAIDS. Report on the global HIV/AIDS epidemic.Geneva: UNAIDS; 2010. 26. Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. The Lancet 2007;369(9562):657-66 27. Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. The lancet. 2007;369(9562):643-56 28. UNAIDS. Moving Forwards: UN Policy and Action on Male Circumcision (Part 3). Geneva: UNAIDS, 2007.

Valadez J. Weiss W LC, Davis R. . Assessing

Community Health Programs: A Trainer’s Guide: Using LQAS for Baseline Surveys and Regular Monitoring. Talc, 2003. 30. Businge D, Smith M.O, Kironde S., and Begumisa A. STAR-EC LQAS Survey Report 2012: A health facility assessment and household LQAS survey on HIV&AIDS and TB interventions in nine districts in East Central Uganda. : STAR-EC 2012. 31. Kelly R, Kiwanuka N, Wawer MJ, et al. Age of male circumcision and risk of prevalent HIV infection in rural Uganda. AIDS 1999;13(3):399-405 32. Siegfried N, Muller M, Deeks JJ, et al. Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev 2009;2. 33. AIDSTAR-One. HIV Prevention Knowledge Base. Biomedical Intervention Voluntary Medical Male Circumcision. Arlington: AIDSTAR-One, 2013. 34. Ministry of Health. Safe Male Circumcision Policy. Kampala: Ministry of Health, 2010.

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