Moving men through the decision making process for Voluntary Medical Male Circumcision (VMMC): An analysis of early versus late adopters
Methods: A cross-sectional survey was facilitated with VMMC clients in rural Tanzania (n=320). Bivariate and multivariate logistic regression was conducted that controlled for access to VMMC services. Standardized weights were applied.
Results: Sixty-five percent (65%) of participants delayed six months or more between first hearing about VMMC and choosing to undergo the VMMC procedure. Most reported cleanliness (95%), protection from disease (92%) and HIV (89%) as motivators; a desire for increased respect and status from men (58%) was also reported, especially among late adopters (adjusted odds ratio (aOR) 2.10, p=.003). Late adopters were more likely to perceive that the majority of men in their community were circumcised (aOR 1.79, p=.015). They were less likely to perceive that HIV testing as part of VMMC influences a man’s decision for VMMC (aOR .50, p=.011), but more likely to report the test as a problem in their own decision making (aOR 2.29, p=.039). Late adopters had greater exposure to VMMC messaging through media (aOR 2.30, p=.011) and family or friends (aOR 1.63, p=.016).
Conclusions: Many men don’t act immediately when learning about VMMC. The transtheoretical model of behavior change and a focus on social norms may benefit programs aiming to move men through the decision making process. Messaging about protection from disease and HIV is also important. The role of HIV testing as a barrier to uptake should be explored further.
Learning Areas:Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Assess the factors influencing the decision to seek VMMC and public health models of behavior change models that may influence this decision.
Keyword(s): Behavioral Research, HIV Interventions
Qualified on the content I am responsible for because: I have been the principal investigator of several studies focusing on the development of interventions to prevent HIV using social science 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.