142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

305452
Moving men through the decision making process for Voluntary Medical Male Circumcision (VMMC): An analysis of early versus late adopters

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 9:15 AM - 9:30 AM

Katherine Andrinopoulos, MHS, PhD , Department of Global Health Systems and Development, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
Erin Peacock, MPH, PhD (ABD) , Department of Global Health Systems and Development, Tulane School of Public Health and Tropical Medicine
Hally Mahler, MPH , MCHIP/Tanzania Volunatry Medical Male Circumcision (VMMC) Program, Jhpiego
Jennifer L. Glick, MPH, PhD (C) , Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine
Elizabeth Edouard, MPA , MCHIP/Tanzania Volunatry Medical Male Circumcision (VMMC) Program, Jhpiego
Renatus Kisendi, MPH , National AIDS Control Program, Ministry of Health and Social Welfare Tanzania
Introduction: VMMC is an important HIV intervention.  We examined differences between early and late adopters of VMMC to inform demand creation activities.   

Methods:  A cross-sectional survey was facilitated with VMMC clients in rural Tanzania (n=320). Bivariate and multivariate logistic regression was conducted that controlled for access to VMMC services.  Standardized weights were applied.   

Results: Sixty-five percent (65%) of participants delayed six months or more between first hearing about VMMC and choosing to undergo the VMMC procedure.  Most reported cleanliness (95%), protection from disease (92%) and HIV (89%) as motivators;  a desire for increased respect and status from men (58%) was also reported, especially among late adopters (adjusted odds ratio (aOR) 2.10, p=.003).  Late adopters were more likely to perceive that the majority of men in their community were circumcised (aOR 1.79, p=.015).  They were less likely to perceive that HIV testing as part of VMMC influences a man’s decision for VMMC (aOR .50, p=.011), but more likely to report the test as a problem in their own decision making (aOR 2.29, p=.039).   Late adopters had greater exposure to VMMC messaging through media (aOR 2.30, p=.011) and family or friends (aOR 1.63, p=.016). 

Conclusions: Many men don’t act immediately when learning about VMMC.  The transtheoretical model of behavior change and a focus on social norms may benefit programs aiming to move men through the decision making process.  Messaging about protection from disease and HIV is also important.  The role of HIV testing as a barrier to uptake should be explored further.

Learning Areas:

Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Assess the factors influencing the decision to seek VMMC and public health models of behavior change models that may influence this decision.

Keyword(s): Behavioral Research, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of several studies focusing on the development of interventions to prevent HIV using social science research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5058.0: HIV Prevention in Africa