An Analysis of Male Circumcision Interpersonal Communication Messages within Uptake of Voluntary Medical Male Circumcision (VMMC) Among Married Men in Busia County, Kenya: A Quantitative Study

Abstract

Voluntary Medical Male circumcision (VMMC) reduces risk of heterosexually acquired HIV. Kenya adopted VMMC as an HIV intervention in 2008 and has been making remarkable progress towards achieving its male circumcision target. However, its uptake is lowest among older and married men. The main objective of this paper is to examine the nature interpersonal communication messages and their influence on uptake of VMMC among married men in Teso South Sub County in Western Kenya. Teso Sub County is among the sub counties with low male circumcision prevalence and high HIV/AIDS prevalence thus a target of the VMMC programme. The survey was carried out between June 15 and July 13, 2017 targeting married men aged between 20 and 49 years. Key constructs and thematic frameworks were developed using health belief model (HBM) and Extended Parallel Process Model (EPPM) and presented verbatim using the participants own words. Based on male circumcision interpersonal communication messages, the findings show that majority respondents including those circumcised perceived HIV/AIDS to be severity and believed they were susceptibility to it. Self-efficacy (confidence in performing a behavior), and especially response efficacy (the belief of efficacious of message) regarding acceptance of VMMC as a preventive measure were the most important correlates of perception. Low response efficacy was the critical problems in adoption of VMMC. Majority of those who had sought VMMC did it for other reasons such as peer pressure, penis appearance, sexual satisfaction and penile hygiene and not for HIV prevention. Among the uncircumcised respondents, majority of those who expressed willingness to adopt male circumcision said it will be for other reasons, not HIV prevention.