Factors associated with low uptake of voluntary male circumcision as an HIV prevention strategy among men between 18-49 years: Case study of Nyanza District

Abstract

Background: Human Immuno-deficiency Virus/Acquired Immune Deficient Syndrome (HIV/AIDS) is the public health burden worldwide. Preventing and treating the diseases including HIV/AIDS Malaria, tuberculosis, Hepatitis, Ebola, and other communicable diseases remains agenda of sustainable development goal and world health organization. To achieve this goal of promoting health through prevention of behavioral risks leading to HIV/AIDS, various health program interventions have been developed in the global settings. Varying perceptions on VMMC outcome may also influence uptake rates. In Rwanda low uptake is mostly due to cultural and religious reasons. Objective: The study aims at assessing the risk factors associated with the low uptake of VMMC as one of the strategies in HIV/AIDS prevention among the adults in Nyanza district. Methods: Cross-sectional study design was conducted among adults male in Nyanza district. Results: The prevalence of voluntary medical male circumcised was 35.8% in Nyanza district. This prevalence was higher than the national prevalence. Almost participants were knowledgeable about VMMC and the knowledge compromised six components that included knowledge on complications, advantage of circumcision in prevention of penile cancer, STIs and HIV prevention, condom use after circumcision, to abstain six weeks after circumcision, improve penile hygiene and heard about VMMC. Religion and education were significant the risk factors of uptake of VMMC. Results indicated that catholic were more likely to get uncircumcised compared to Muslim [OR=7.187(1.742-29.659), p=0.01]. The believers from other churches had more risk to get uncircumcised compared to Muslim [OR=6.035(1.73121.039), p=.005]. In bivariate analysis, the results indicated that the participants who had secondary education were more likely to get uncircumcised compared to the adults males with primary education [OR=1.4(0.74-2.64), p=0.03] and who were illiterate were more likely to get uncircumcised compared to the individuals with primary education (OR=0.37(0.15-0.92), p=0.034]. Conclusion: Many of the study participants were uncircumcised male, but most of them had sufficient knowledge about MMC and its prevalence was slightly high compared to the countrywide. Factors which were associated with low uptake may be modified them the population may attend circumcision services as required. Programs targeting peers and parents as they are important referent others who have the ability to influence their peers