Male circumcision uptake and misperceived norms about male circumcision: Cross-sectional, population-based study in rural Uganda.

Autor:	Perkins JM; Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA.; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Kakuhikire B; Mbarara University of Science and Technology, Mbarara, Uganda., Baguma C; Mbarara University of Science and Technology, Mbarara, Uganda., Jeon S; Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA., Walker SF; Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA., Dongre R; Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA., Kyokunda V; Mbarara University of Science and Technology, Mbarara, Uganda., Juliet M; Mbarara University of Science and Technology, Mbarara, Uganda., Satinsky EN; Department of Psychology, University of Southern California, Los Angeles, California, USA.; Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA., Comfort AB; Bixby Center for Global Reproductive Health, University of California, San Franciso, California, USA., Siedner MJ; Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.; Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA., Ashaba S; Mbarara University of Science and Technology, Mbarara, Uganda., Tsai AC; Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.; Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Journal of global health [J Glob Health] 2023 Dec 20; Vol. 13, pp. 04149. Date of Electronic Publication: 2023 Dec 20.
DOI:	10.7189/jogh.13.04149
Abstrakt:	Background: Over the past decade, 15 high-priority countries in eastern and southern Africa have promoted voluntary medical male circumcision for human immunodeficiency virus (HIV) and sexually transmitted infection (STI) prevention. The prevalence of male circumcision in Uganda nearly doubled from 26% in 2011 to 43% in 2016, but remains below the 2020 target level. Little is known about how common male circumcision is perceived to be, how accurate such perceptions are, and whether they are associated with men's own circumcision uptake. Methods: We conducted a cross-sectional study of all adult residents of eight villages in Rwampara District, southwestern Uganda in 2020-2022. We elicited their perceptions of the adult male circumcision prevalence within their village: >50% (most men), 10% to <50% (some), <10%, (few to none), or do not know. We compared their perceived norms to the aggregated prevalence of circumcision reported in these villages. We used a modified multivariable Poisson regression model to estimate the association between perceived norms and personal circumcision uptake among men. Results: We surveyed 1566 participants (91% response rate): 698 men and 868 women. Among the men, 167 (27%) reported being circumcised, including 167/444 (38%) men <50 years of age. Approximately one-fourth of the population (189 (27%) men and 177 (20%) women) believed that few to no men in their own village had been circumcised. In a multivariable regression model, men who underestimated the prevalence of male circumcision were less likely to be circumcised themselves (adjusted relative risk (aRR) = 0.51; 95% confidence interval (CI) = 0.37-0.83). Conclusions: In this population-based study in rural Uganda, one-fourth of men underestimated the prevalence of male circumcision. Men who underestimated the extent of circumcision uptake were themselves less likely to be circumcised. If the observed association is causal and underestimates within the population contribute to low uptake, then interventions correcting these misperceived norms could increase uptake of voluntary medical male circumcision. Competing Interests: Disclosure of Interests: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare that ACT is a member of the Journal of Global Health editorial board and reports receiving a financial honorarium from Elsevier, Inc. for his work as Co-Editor in Chief of the Elsevier-owned journal SSM-Mental Health. (Copyright © 2023 by the Journal of Global Health. All rights reserved.)
Databáze:	MEDLINE
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