Abstract
BackgroundDespite the protective effect of male circumcision (MC) against HIV in men, the acceptance of voluntary MC in priority countries for MC scale–up such as Uganda remains limited. This study examined the role of women’s sociodemographic characteristics, knowledge of HIV and sexual bargaining power as determinants of women’s support of male circumcision (MC).MethodsData from the Uganda AIDS Indicator Survey, 2011 were analyzed (n = 4,874). Bivariate and multivariate logistic regression analyses with random intercept were conducted to identify factors that influence women’s support of MC.ResultsOverall, 67.0 % (n = 3,276) of the women in our sample were in support of MC but only 28.0 % had circumcised partners. Women who had the knowledge that circumcision reduces HIV risk were about 6 times as likely to support MC than women who lacked that knowledge [AOR (adjusted odds ratio) = 5.85, 95 % CI (confidence interval) = 4.83–7.10]. The two indicators of women’s sexual bargaining power (i.e., ability to negotiate condom use and ability to refuse sex) were also positively associated with support of MC. Several sociodemographic factors particularly wealth index were also positively associated with women’s support of MC.ConclusionsThe findings in this study will potentially inform intervention strategies to enhance uptake of male circumcision as a strategy to reduce HIV transmission in Uganda.
Highlights
Despite the protective effect of male circumcision (MC) against human immunodeficiency virus (HIV) in men, the acceptance of voluntary MC in priority countries for MC scale–up such as Uganda remains limited
Men are the main focus of male circumcision (MMC) education, the literature shows that women can play a central role in the scale-up of MMC [9,10,11,12,13]
Women play a key role in encouraging men to get circumcised and they may be valuable in strategies for increasing MMC uptake [9, 15, 16]
Summary
Despite the protective effect of male circumcision (MC) against HIV in men, the acceptance of voluntary MC in priority countries for MC scale–up such as Uganda remains limited. There is a growing appeal from the World Health Organization (WHO), the UN Joint Program on HIV/ AIDS (UNAIDS) and the President’s Emergency Plan for AIDS Relief (PEPFAR) for quick scale–up of medical male circumcision (MMC) in areas of high HIV prevalence in sub–Saharan Africa [1,2,3]. The interest of these organizations in MMC follows findings from several studies, which include three randomized control trials that demonstrated a protective effect of MMC against HIV in men [4,5,6]. It is important to investigate the determinants of support for MMC among females
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