6533b7d2fe1ef96bd125ecfc
RESEARCH PRODUCT
Sequential Cross-Sectional Surveys in Orange Farm, a Township of South Africa, Revealed a Constant Low Voluntary Medical Male Circumcision Uptake among Adults despite Demand Creation Campaigns and High Acceptability
Florence HlatswayoDumazile XabaMotlalepule TsepeCornelius MonkweEsaie MarshallSimphiwe KhelaSimphiwe TshabalalaLindo XuluBertran AuvertAdrian PurenThobile MalingaTebogo MolomoReathe Rain-taljaardsubject
RNA virusesMaleCross-sectional studyEpidemiologyPrevalenceSocial Scienceslcsh:MedicineHIV InfectionsOrange (colour)Pathology and Laboratory MedicineGeographical locationsCultural AnthropologySouth Africa0302 clinical medicineImmunodeficiency VirusesSociologyEnvironmental protectionCircumcisionMedicine and Health SciencesPrevalenceMedicine030212 general & internal medicineYoung adultReproductive System Procedureslcsh:ScienceMultidisciplinarySchoolsMiddle Aged3. Good healthReligionMale circumcisionMedical MicrobiologyHIV epidemiologyViral PathogensVirusesInfectious diseasesPathogens0305 other medical scienceDemand creationResearch ArticleAdultAdolescentSurgical and Invasive Medical ProceduresViral diseasesMicrobiologyEducation03 medical and health sciencesYoung AdultRetrovirusesAdultsHumansSex organMicrobial Pathogens030505 public healthbusiness.industryLentiviruslcsh:ROrganismsBiology and Life SciencesHIVPatient Acceptance of Health CareCross-Sectional StudiesCircumcision MaleTurnoverAge GroupsAnthropologyPeople and PlacesAfricaPopulation Groupingslcsh:Qbusiness[SDV.MHEP]Life Sciences [q-bio]/Human health and pathologyDemographydescription
Background WHO recommends a male circumcision (MC) prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC) clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126). Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18–19 and 18–49 years in the past 5 years. Methods A cross-sectional survey (ANRS-12285) was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire. Results MC prevalence rate among young adult men aged 18–19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0%) in 2010 to 87.5% (76.0% to 94.6%) in 2015 (p<0.001). In the same period, among men aged 18–49 years, MC prevalence rate varied slightly from 55.4% (53.6% to 57.1%) to 56.7% (52.4% to 60.9%). In 2015, 84.9% (79.2% to 89.5%) of uncircumcised adult men reported that they were willing to be circumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9%) of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9%) who reported that they were definitely willing to become circumcised. Conclusions In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-07-18 |