Application of an HIV Prevention Cascade to Identify Gaps in Increasing Coverage of Voluntary Medical Male Circumcision Services in 42 Rural Zambian Communities.

Autor: Hensen B; Clinical Research Department, Infectious and Tropical Diseases, The London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Bernadette.hensen@lshtm.ac.uk., Fearon E; Public Health, Environments and Society, Public Health and Policy, The London School of Hygiene and Tropical Medicine, London, UK., Schaap A; Infectious Disease Epidemiology, Epidemiology and Population Health, The London School of Hygiene and Tropical Medicine, London, UK.; Zambart, University of Zambia, Lusaka, Zambia., Lewis JJ; Infectious Disease Epidemiology, Epidemiology and Population Health, The London School of Hygiene and Tropical Medicine, London, UK., Weiss HA; Infectious Disease Epidemiology, Epidemiology and Population Health, The London School of Hygiene and Tropical Medicine, London, UK., Tembo M; Zambart, University of Zambia, Lusaka, Zambia., Chintu N; Society for Family Health, Lusaka, Zambia., Ayles H; Clinical Research Department, Infectious and Tropical Diseases, The London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; Zambart, University of Zambia, Lusaka, Zambia., Hargreaves JR; Public Health, Environments and Society, Public Health and Policy, The London School of Hygiene and Tropical Medicine, London, UK.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2019 May; Vol. 23 (5), pp. 1095-1103.
DOI: 10.1007/s10461-019-02407-w
Abstrakt: Increased coverage of voluntary medical male circumcision (VMMC) is needed in countries with high HIV prevalence. We applied an HIV-prevention cascade to identify gaps in male circumcision coverage in Zambia. We used survey data collected in 2013 and 2014/15 to describe circumcision coverage at each time-point, and prevalence of variables related to demand for and supply of VMMC. We explored whether circumcision coverage in 2014/15 was associated with demand and supply among uncircumcised men in 2013. Results show that circumcision coverage was 11.5% in 2013 and 18.0% in 2014/15. Levels of having heard of circumcision and agreeing with prevention benefits was similar at both time-points (79.8% vs 83.2%, and 49.7% vs 50.7%, respectively). In 2013, 39.3% of men perceived services to be available compared to 54.7% in 2014/15. Levels of having heard of circumcision in 2013 was correlated with and higher perceived service availability associated with coverage in 2014/15. VMMC coverage was low in these study sites. Knowledge of prevention tools and of service availability are necessary to increase coverage but alone are insufficient.
Databáze: MEDLINE
Externí odkaz: