Pascal Nzamwita1,2, Emmanuel Biracyaza1,3. 1. Department of Community Health, School of Public Health, University of Rwanda, Kigali, Rwanda. 2. Department of Prevention, ADIS Healthcare Foundation (AHF) Rwanda, Kigali, Rwanda. 3. District Manager of Sociotherapy Programme, Prison Fellowship Rwanda (PFR), Kigali, Rwanda.
Abstract
BACKGROUND: Voluntary medical male circumcision (VMMC) is an effective biomedical intervention against HIV in developed and developing countries. However, there is low uptake of VMMC due to various factors, which hinders achievement of health-policy goals to increase uptake. Numerous campaigns offering the procedure free of charge exist in developing countries, but such initiatives seem to bear little fruit in attracting men to these services. This study assessed risk factors associated with the low uptake of VMMC among men in Nyanza district, Southern Province, Rwanda. METHODS: A cross-sectional study was conducted among adult males in Nyanza. A total of 438 men participated in individual interviews. Bivariate and multivariate logistic regression models were used with 95% confidence intervals and p≤0.05 was taken as statistically significant. RESULTS: Our results indicated that a low update of VMMC was highly prevalent (35.8%). A majority (84.7%) of participants had heard about VMMC, its complications, advantages in preventiing penile cancer, sexually transmitted infections, and HIV, condom use after circumcision, abstinence for 6 weeks after circumcision, and improving penile hygiene. Religion and education were significant factors in low uptake. Catholics were less likely to undergo VMMC than Muslims (OR 7.19, 95% CI 1.742-29.659; p=0.01). Those of other faiths were less likely to undergo VMMC than Muslims (OR 6.035, 95% CI 1.731-21.039; p=0.005). Participants with secondary education were less likely to undergo VMMC than those with primary education only (OR 1.4, 95% CI 0.74-2.64; p=0.03). Having no formal education decreased the odds of being uncircumcised (OR 0.37, 95% CI 0.14-0.977; p=0.045) when compared to those with primary education. CONCLUSION: Uptake of VMMC remains low in Nyanza, but most men had sufficient knowledge about it. Education, religion, and marital status were major factors in the low uptake. Programs targeting peer influences and parents need to be prioritized.
BACKGROUND: Voluntary medical male circumcision (VMMC) is an effective biomedical intervention against HIV in developed and developing countries. However, there is low uptake of VMMC due to various factors, which hinders achievement of health-policy goals to increase uptake. Numerous campaigns offering the procedure free of charge exist in developing countries, but such initiatives seem to bear little fruit in attracting men to these services. This study assessed risk factors associated with the low uptake of VMMC among men in Nyanza district, Southern Province, Rwanda. METHODS: A cross-sectional study was conducted among adult males in Nyanza. A total of 438 men participated in individual interviews. Bivariate and multivariate logistic regression models were used with 95% confidence intervals and p≤0.05 was taken as statistically significant. RESULTS: Our results indicated that a low update of VMMC was highly prevalent (35.8%). A majority (84.7%) of participants had heard about VMMC, its complications, advantages in preventiing penile cancer, sexually transmitted infections, and HIV, condom use after circumcision, abstinence for 6 weeks after circumcision, and improving penile hygiene. Religion and education were significant factors in low uptake. Catholics were less likely to undergo VMMC than Muslims (OR 7.19, 95% CI 1.742-29.659; p=0.01). Those of other faiths were less likely to undergo VMMC than Muslims (OR 6.035, 95% CI 1.731-21.039; p=0.005). Participants with secondary education were less likely to undergo VMMC than those with primary education only (OR 1.4, 95% CI 0.74-2.64; p=0.03). Having no formal education decreased the odds of being uncircumcised (OR 0.37, 95% CI 0.14-0.977; p=0.045) when compared to those with primary education. CONCLUSION: Uptake of VMMC remains low in Nyanza, but most men had sufficient knowledge about it. Education, religion, and marital status were major factors in the low uptake. Programs targeting peer influences and parents need to be prioritized.
Authors: Zulfiqar A Bhutta; Johannes Sommerfeld; Zohra S Lassi; Rehana A Salam; Jai K Das Journal: Infect Dis Poverty Date: 2014-07-31 Impact factor: 4.520
Authors: Victoria K Ngo; Adolfo Rubinstein; Vijay Ganju; Pamela Kanellis; Nasser Loza; Cristina Rabadan-Diehl; Abdallah S Daar Journal: PLoS Med Date: 2013-05-14 Impact factor: 11.069
Authors: Michelle R Kaufman; Marina Smelyanskaya; Lynn M Van Lith; Elizabeth C Mallalieu; Aliza Waxman; Karin Hatzhold; Arik V Marcell; Susan Kasedde; Gissenge Lija; Nina Hasen; Gertrude Ncube; Julia L Samuelson; Collen Bonnecwe; Kim Seifert-Ahanda; Emmanuel Njeuhmeli; Aaron A R Tobian Journal: PLoS One Date: 2016-03-03 Impact factor: 3.240
Authors: Barbara Marjorie Nanteza; David Serwadda; Edward Nelson Kankaka; Grace Bua Mongo; Ronald Gray; Frederick Edward Makumbi Journal: BMC Public Health Date: 2018-11-20 Impact factor: 3.295
Authors: Marco Bandini; Mohamed Ahmed; Giuseppe Basile; Nicholas Watkin; Viraj Master; Yao Zhu; Gagan Prakash; Alejandro Rodriguez; Mbaaga K Ssebakumba; Riccardo Leni; Giuseppe Ottone Cirulli; Ben Ayres; Rachel Compitello; Filippo Pederzoli; Pankaj M Joshi; Sanjay B Kulkarni; Francesco Montorsi; Guru Sonpavde; Andrea Necchi; Philippe E Spiess Journal: Nat Rev Urol Date: 2021-12-22 Impact factor: 16.430