Male circumcision: Healthcare providers' current level of knowledge and associated factors

Background: Three international randomized-controlled trials as well as several domestic observational studies have demonstrated that male circumcision (MC) reduces the transmission of HIV and other STIs. Yet, MC rates are declining in the U.S. In response, the CDC and AAP recommend that healthcare providers understand MC risks and benefits to foster informed decision making with parent(s)/guardian(s).

Objective: The purpose is to examine healthcare providers' level of knowledge pertaining to MC risks and benefits and what characteristics influence these levels.

Methods: To examine MC knowledge, a 17-point summary score was constructed through an online survey, and administered to providers in pediatrics, obstetrics/gynecology, and family medicine at an urban medical center.

Results: 92 providers completed the survey, generating a 71% response rate. The population identified as 78% female, 83% physician/resident/fellow, 52% white, and 41% between 30-39 years.

23% of providers correctly indicated that MC reduces the risk of HIV transmission by 60%. Participants scored low for the following items: protection against cervical cancer(44% correct), genital ulcer disease(19%), and bacterial vaginosis(14%).

Three models were constructed looking at (1)overall knowledge about MC, (2)knowledge regarding the relationships between MC and STIs, and (3)knowledge about MC and HIV transmission. The results indicated that pediatricians demonstrated a greater overall MC knowledge, while obstetricians scored significantly higher for the STIs and HIV knowledge items.

Conclusions: Providers' scored low regarding the associations between MC and HIV and STIs; thus warranting an educational intervention illustrating the risks and benefits. The results further demonstrate that one's department impacts MC knowledge significantly.