Cecilia Milford1, Letitia Rambally2, Joanne E Mantell3, Elizabeth A Kelvin4, Nzwakie F Mosery2, Jennifer A Smit2. 1. MatCH Research (Maternal, Adolescent and Child Health Research), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa. Electronic address: cmilford@matchresearch.co.za. 2. MatCH Research (Maternal, Adolescent and Child Health Research), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa. 3. HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, USA. 4. HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality and Health, NY State Psychiatric Institute and Columbia University, USA; CUNY School of Public Health, Hunter College, City University of New York, USA.
Abstract
BACKGROUND: Medical male circumcision has been shown to reduce HIV transmission to an uninfected male partner. In South Africa, medical male circumcision programs were rolled-out in 2010. OBJECTIVES: Prior to roll-out, we explored healthcare providers' knowledge, attitudes and practices about medical male circumcision and their understandings of partial efficacy for HIV prevention. DESIGN: We conducted qualitative research, using in-depth interviews. SETTING: Participants were from three rural and three urban primary healthcare clinics, randomly selected in eThekwini District, KwaZulu-Natal. PARTICIPANTS: 25 healthcare providers (including nurse managers, nurses and counselors) were purposively selected from the clinics. METHODS: In-depth interviews were recorded, transcribed and translated. Independent researchers reviewed the transcripts and developed a codebook based on emergent themes, using thematic analysis. NVivo 8 was used to facilitate data management, coding and analysis. RESULTS: Although most providers had heard that medical male circumcision can reduce risk of HIV acquisition in men, most did not have accurate scientific understandings of this. Some providers had misperceptions about the limited/partial protection medical male circumcision offers. Many had concerns that their communities would misunderstand it, causing increased risky sexual behavior. CONCLUSIONS: These data provide a baseline of providers' understandings of medical male circumcision prior to roll-out, and can be used to compare current data and ensure accurate messaging to clients. Healthcare provider messaging should build client understandings of the meaning of partially efficacious technologies.
BACKGROUND: Medical male circumcision has been shown to reduce HIV transmission to an uninfected male partner. In South Africa, medical male circumcision programs were rolled-out in 2010. OBJECTIVES: Prior to roll-out, we explored healthcare providers' knowledge, attitudes and practices about medical male circumcision and their understandings of partial efficacy for HIV prevention. DESIGN: We conducted qualitative research, using in-depth interviews. SETTING:Participants were from three rural and three urban primary healthcare clinics, randomly selected in eThekwini District, KwaZulu-Natal. PARTICIPANTS: 25 healthcare providers (including nurse managers, nurses and counselors) were purposively selected from the clinics. METHODS: In-depth interviews were recorded, transcribed and translated. Independent researchers reviewed the transcripts and developed a codebook based on emergent themes, using thematic analysis. NVivo 8 was used to facilitate data management, coding and analysis. RESULTS: Although most providers had heard that medical male circumcision can reduce risk of HIV acquisition in men, most did not have accurate scientific understandings of this. Some providers had misperceptions about the limited/partial protection medical male circumcision offers. Many had concerns that their communities would misunderstand it, causing increased risky sexual behavior. CONCLUSIONS: These data provide a baseline of providers' understandings of medical male circumcision prior to roll-out, and can be used to compare current data and ensure accurate messaging to clients. Healthcare provider messaging should build client understandings of the meaning of partially efficacious technologies.
Authors: Lisa M Albert; Angela Akol; Kelly L'Engle; Elizabeth E Tolley; Catalina B Ramirez; Alex Opio; Nazarius M Tumwesigye; Sarah Thomsen; Stella Neema; Sebastian O Baine Journal: AIDS Care Date: 2011-07-07
Authors: Joanne E Mantell; Jennifer A Smit; Jane L Saffitz; Cecilia Milford; Nzwakie Mosery; Zonke Mabude; Nonkululeko Tesfay; Sibusiso Sibiya; Letitia Rambally; Tsitsi B Masvawure; Elizabeth A Kelvin; Zena A Stein Journal: Sex Health Date: 2013-05 Impact factor: 2.706
Authors: Timothy B Hallett; Ramzi A Alsallaq; Jared M Baeten; Helen Weiss; Connie Celum; Ron Gray; Laith Abu-Raddad Journal: Sex Transm Infect Date: 2010-10-21 Impact factor: 3.519