Barcelona 2013
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| Abstract #186 - Biomedical Prevention | ||||
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Session: 40.6: Biomedical Prevention (Parallel) on Tuesday @ 16.30-18.30 in Raval Chaired by Olive Shisana, Chinese Authors: Presenting Author: Prof. Joseph Lau - The Jockey Club School of Public Health, The Chinese University of Hong Kong, Hong Kong |
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| Additional Authors: Dr. Prashant Sharma, Dr. Manorama Bhargava, | ||||
| Aim: Heterosexual transmission is the leading mode of HIV transmission in China but there is a dearth of evidence-based interventions targeting high risk heterosexual males. Male circumcision (MC), which has been under-utilized in China, is one of such interventions; WHO and UNAIDS recommend it to be used for HIV prevention among male heterosexuals. No implementation study has been conducted in Asia. In Phase I, we investigated the prevalence and associated factors of willingness to take up MC, conditional of effectiveness in HIV/STD risk reduction, among heterosexual male sexually transmitted diseases (STD) patients in Shenzhen, China. In phase II, we implemented a theory-based and clinic-based test-of-concept intervention based on the Phase I findings to promote MC within a 4-month post-intervention period. | ||||
| Method / Issue: In Phase I, 308 HIV negative, uncircumcised and consented heterosexual male STD patients recruited from three STD clinics in Shenzhen were interviewed anonymously. Health Belief Model (HBM) was used for variables selection. In Phase II, another sample of 179 such patients participated in an intervention (a 10-minute video and brief consultation) promoting MC. They were followed up by telephone four months afterwards. | ||||
| Results / Comments: Many of the male STD patients had risky behaviors and previous STD history. Briefed by a statement that MC could reduce risk of HIV infection by 50%, 46.1% of the participants were willing to take up MC in the future six months. The multivariate analysis showed that age >40 years old (OR=0.39), good HIV-related knowledge (OR=2.61), previous STD history in the last three years (OR=4.78), overly long foreskin (OR=3.31), perceived chance of having sex with HIV positive women (OR=3.60), higher score in scales reflecting perceived severity of STD (OR=1.09), risk reduction in HIV/STD due to MC (OR=1.36), improvement in sexual performance due to MC (OR=1.30), cue to action (OR=1.49) and self-efficacy for MC (OR=1.39) were significantly associated with acceptability of MC (p<.05). During the 4-month period, 25 out of the 156 participants (16.0%) being followed up had taken up MC. 44 of the 131 uncircumcised participants (33.6%) would like to take up MC in the future six months, whilst 13 of these 44 participants (29.5%) had made clear plan (time & venue) to take up MC in the future three months. | ||||
| Discussion: The theory of HBM can be used to explain acceptability of MC and to design a simple clinic-based intervention which is highly sustainable. Future translational studies to create regular services promoting MC in this high-risk population are warranted. | ||||
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