Increasing early infant male circumcision uptake in Zambia: Like father like son.

Autor: Weiss SM; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America., Rodriguez VJ; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.; Department of Psychology, University of Georgia, Athens, Georgia, United States of America., Cook RR; Medicine, General Internal Medicine, and Geriatrics, Oregon Health & Science University, Portland, Oregon, United States of America., Bowa K; University of Lusaka School of Medicine, Lusaka, Zambia., Zulu R; University of Zambia School of Medicine, Lusaka, Zambia., Mweemba O; Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia., Kamboyi R; Ministry of Health, Lusaka, Zambia., Castro J; Division of Infectious Diseases, Dept. of Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America., Dunleavy VO; School of Communication, University of Miami, Miami, Florida, United States of America., Alcaide ML; Division of Infectious Diseases, Dept. of Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America., Jones DL; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 10; Vol. 18 (8), pp. e0289819. Date of Electronic Publication: 2023 Aug 10 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0289819
Abstrakt: Voluntary Medical Male Circumcision (VMMC) is an effective strategy for HIV prevention in areas with high prevalence of, and risk for, HIV. More than 361,000 male neonates are born each year in Zambia, many of whom could be eligible for Early-Infant Medical Circumcision (EIMC). Building on successful implementation strategies utilized in our Spear & Shield program, this pilot study, "Like Father, Like Son" (LFLS), evaluated the feasibility and acceptability of offering combined EIMC and VMMC services and couple-level behavioral interventions. A total of N = 702 pregnant women and their male partners (n = 351 couples) were recruited and enrolled. Couples were assessed twice pre-birth, 2 weeks post birth, and 6 months post birth. Expectant mothers were an average of 15.05 weeks pregnant (SD = 8.83). Thirty-nine pregnancies did not result in a live birth (11%), 14 couples withdrew from the study or were lost to follow-up prior to delivery (4%), and 148 babies were born female (42%), leaving 150 couples with a male infant in the analytic sample (43%). The LFLS study achieved significantly higher EIMC rates (35%) in comparison with previously observed EIMC study rates in Zambia (11%), and significantly higher than hypothetical comparison rates up to 30%. Relative to baseline rates, odds of VMMC among couples' older sons increased by 31% at post-intervention and by 90% at two-weeks following birth. Overall, this pilot study found the LFLS intervention to be feasible, acceptable, and effective in doubling the rate of EIMC in comparison with a previous longitudinal study in Zambia. Future research should consider a family-centric approach to promotion of male circumcision for infants and adolescents. LFLS may be effective in promoting father-son "bonding" by MC status; a bond that may be a bridge to increase both EIMC and VMMC uptake in newborns and couples' older sons and is a novel leverage point for promotion of this HIV prevention strategy.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Weiss et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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