142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Role of Women in Voluntary Medical Male Circumcision (VMMC) Decision Making among Men in Tanzania

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 9:00 AM - 9:15 AM

Jennifer Lauren Glick, MPH, Phd candidate , Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, new orleans, LA
Katherine Andrinopoulos, PhD , Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Erin Peacock, MPH, PhD (ABD) , Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Elizabeth Edouard, MPA , MCHIP/Tanzania Volunatry Medical Male Circumcision (VMMC) Program, Jhpiego
Hally Mahler, MHS , MCHIP/Tanzania Volunatry Medical Male Circumcision (VMMC) Program, Jhpiego, Dar es Salaam, Tanzania
Renatus Kisendi, MPH , National AIDS Control Program, Ministry of Health and Social Welfare Tanzania
Background: Given evidence of a 60% reduction in HIV acquisition for circumcised men, we examined the role of women in clients’ decision to seek services through the VMMC program implemented in the Iringa and Njombe regions of Tanzania.   

Methods: A cross sectional study was conducted including in-depth interviews (IDIs) with VMMC clients (n=30; n=12 HIV-positive), IDIs with VMMC service providers and stakeholders (n=30), and surveys with VMMC clients (n=320).  IDI transcripts were analyzed through coding and identification of key themes.  Surveys were analyzed at the univariate and bivariate level, utilizing standardized sampling weights.  

 Results: Women influenced men’s decision making for VMMC in a variety of ways.  Women interacted with the formal health care system more regularly and served as message bearers to male partners.  Among VMMC clients, 18.1% reported discussing their VMMC decision making with a wife or sexual partner.  New notions of sexual desirability were connected with male circumcision for disease risk reduction, aesthetic preferences, and sexual pleasure enhancement.   A belief that circumcision is more desirable to women was reported by 31.7% of men as one reason they decided to circumcise. However, male clients expressed discomfort with female VMMC providers and interacting with women while seeking services. Embarrassment was a main obstacle in VMMC decision making for 12.8% of clients surveyed, 40.9% believed this is an obstacle for their uncircumcised counterparts.

Conclusion: Considering these small but significant numbers, women’s ability to both persuade and dissuade men to participate in VMMC services should be considered in VMMC demand creation interventions.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss the role of women in Voluntary Medical Male Circumcision (VMMC) decision making among men in Tanzania

Keyword(s): HIV/AIDS, Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am pursuing my Phd at Tulane University and hold a MPH degree and a graduate certificate in gender and sexuality studies. I have an interest in the intersections of gender, sexuality, and public health. Iím involved in research on Voluntary Medical Male Circumcision, HIV risk reduction practices among female sex workers, and HIV surveillance among transgender individuals. Additional interests include: mixed methods research, respondent driven sampling, social determinants of health, community participatory action research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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