Factors associated with uptake of voluntary medical male circumcision services among adult males in Ludewa district council, Njombe region

Abstract

Background: Male circumcision is the removal of some or the entire foreskin of the penis. In 2007, World Health Organization (WHO) adopted and recommended Voluntary Medical Male Circumcision (VMMC) to be implemented as an intervention for HIV prevention particularly in the country with high prevalence of HIV and low prevalence of Male circumcision. Since VMMC programme started in Ludewa DC in 2011 and early 2015, 83% of the procedures performed were for <20 years old clients. Little information are available on the factors associated with the uptake of VMMC services among adult males aged >20 years. Hence this study aimed to identify factors influencing uptake of voluntary medical male circumcision services among adult males aged >20 years in Ludewa DC. Materials and methods: An analytical cross-sectional study design was utilized. A multistage probability sampling method was used to randomly select adult males aged >20 years to be included in the study. Structured interviewer administered questionnaire was used in data collection. Data was entered, cleaned and analysed using Epi info version 3.5.1. The p-value of <0.05 and OR at 95% was set as statistical significance level. Chi-square test was performed at bivariate level and those variables with p<0.2 were entered in Multiple logistic regression model to control for confounding and identify factors that are independently associated with uptake of VMMC services. Results: A total of 326 adult males aged >20 years were recruited in the study with the median age of 33 years (range 20 to 67 years). More than two third (66.6%) of the study respondents were circumcised. Having secondary and above education level (AOR=4.49; 95%CI: 2.58-7.81), availability of VMMC services (AOR=2.19; 95%CI: 1.21-3.96), pleasing of female partners (AOR=2.83; 95%CI: 1.63-4.93) and social support (AOR=1.78; 95%CI: 1.03-3.09) were independently associated with the uptake of VMMC services Conclusion and Recommendation: In this study, availability of VMMC services, education level, female partner support and social support were independently associated with uptake of VMMC services. Therefore, in order to increase coverage of circumcised adult males, involvement of women in the programme should be strengthened and also health education for addressing barriers to uptake of VMMC services should be developed and implemented.