Barcelona 2013
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| Abstract #219 - Biomedical Prevention | ||||
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Session: 40.7: Biomedical Prevention (Parallel) on Tuesday @ 16.30-18.30 in Raval Chaired by Olive Shisana, Chinese Authors: Presenting Author: Mr Gavin George - University of KwaZulu-Natal, South Africa |
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| Additional Authors: Dr. Prashant Sharma, Dr. Manorama Bhargava, | ||||
| Aim: Epidemiological and economic modelling concluded that if VMMC is scaled up in appropriate settings it constitutes a high-impact HIV intervention. South Africa has targeted 4.4 million men for VMMC by 2015 with only 2.7% of the target (500,000) achieved by the end of 2010. A qualitative study was conducted in a high HIV prevalence district in KwaZulu-Natal, South Africa, to identify barriers and facilitators to the uptake of VMMC amongst adolescent boys. | ||||
| Method / Issue: Twelve focus group discussions (FGDs) with boys who had undergone VMMC and seven FGDs with boys who had chosen not to undergo circumcision were conducted in late 2012 and early 2013. The framework approach provided a systematic structure for analysis, allowing for a-priori and emergent codes to be used for the analysis of data. Analysis was guided by the Social Cognitive Theory with the research focusing on both cognitive and structural factors influencing VMMC uptake. | ||||
| Results / Comments: Cognitive factors facilitating uptake included the belief that VMMC reduced the risk of HIV infection, lead to better hygiene and improvement in sexual desirability and performance. Cognitive barriers related to the fear of HIV testing (and the subsequent result) which preceded VMMC. Other barriers related to the pain associated with the procedure and adverse events. The need to abstain from sex during the six week healing period was a further prohibiting factor for boys. Structural facilitators included the support of VMMC from Principals and educators as well as the community which was achieved through extensive dialogue with service providers. The provision of transport and the ?quality of care? provided by the VMMC clinic were important factors associated with uptake. Timing was crucial, as boys were reluctant to get circumcised when involved in sporting activities and during exam periods. | ||||
| Discussion: Targeting adolescents for VMMC is successful when coupled with the correct messaging. Enhanced sexual pleasure and performance (for both males and females) and hygiene are common reasons for undergoing circumcision. Demand creation activities need to focus on the benefits of HIV testing and other non-HIV benefits of VMMC. Timing of VMMC interventions needs to be considered when targeting school going boys. | ||||
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