Acceptability of male infant medical circumcision as an HIV prevention strategy among patients attending a Health Centre IV in Kampala District

Abstract

Background: Medical Male Circumcision (MMC) has been shown to reduce the risk of HIV infection by 50-60%. UNAIDS has recommended that MMC be integrated into prevention strategies in countries of high prevalence. Circumcision in infancy has the added advantages of being easier to perform and cheaper through faster healing and less complications. Objectives: The general objective was to establish the factors that influence acceptability of Male Infant Medical Circumcision (MIMC) as an HIV prevention strategy. The specific objectives were to determine knowledge of Male Medical Circumcision (MMC) and identify factors influencing acceptability of MIMC. Methods: A descriptive cross sectional design was used. Participants were selected randomly from people attending a health centre. Data from consenting adults aged 18 years and above was collected using interviewer administered questionnaires. Bivariate analysis to determine factors associated with acceptability and logistic regression was done to remove confounders. Odds ratios (ORs), 95% confidence intervals and p values are reported. Results: A total of 323 participants were interviewed. The mean age was 28.6 with a SD of 9 years. One hundred ninety three of them had 1 or more male children. At bivariate analysis, positive associations with acceptability were prior knowledge of Male Medical Circumcision (MMC) and a belief that MMC improved personal hygiene and prevented STDS/HIV. More than 80% of the respondents preferred circumcision in infancy because of a belief that it healed faster. Significant predictors of acceptability at multivariate analysis were found with being female (AOR 3.36; 95%CI 1.14-9.8), having knowledge about the preventive effect of MMC (AOR 5.61 95%CI 1.17-26.92), perceived family approval for MMC (AOR 23.59; 95%CI 6.43-86.50), and if the service were to be provided safely at affordable prices (AOR 3.27 95%CI1.17-917). Conclusion: MIMC appears to be highly acceptable in Kampala. The option for safe and affordable MIMC should be made available to all parents.