Factors Associated with the Acceptability of Male Circumcision among Men in Jamaica

Melonie M Walcott,Maung Aung,Pauline E Jolly,Ellen Funkhouser,Mirjam C Kempf,John E Ehiri,Deborah Hickman,Kui Zhang

doi:10.1371/journal.pone.0075074

Melonie M Walcott, Maung Aung + Show 6 more

Open Access

https://doi.org/10.1371/journal.pone.0075074

Copy DOI

Abstract

ObjectivesTo determine the prevalence of male circumcision (MC) among men in the western region of Jamaica, and to identify factors associated with acceptability of MC for self, infants (<1 year) and older sons (1-17 years).MethodsA cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years was conducted in the western region of Jamaica. The survey included questions about the acceptance of MC for self, infants, and sons before and after an information session about the benefits of MC in preventing HIV/STI transmission. Logistic regression models were used to identify factors that were associated with acceptability of MC. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated from the models.ResultsFourteen percent of the men reported that they were circumcised. In the multivariable model, which adjusted for age, education, religion and income, there were increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1-15.9), believed they would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0-8.2), and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8-4.8). Similarly, uncircumcised men who reported no concerns about MC or who believed that they would experience more pleasure during sex if circumcised were more likely to accept MC for self.ConclusionProviding men with information about MC increased acceptance of MC for self, infants (<17 years) and sons (1-17 years). Since targeted education on the benefits of male circumcision for prevention of HIV/STI can be effective in increasing acceptability of MC, health professionals should be trained, and willing to discuss MC with men in healthcare facilities and in the community.

Highlights

In 2007, the World Health Organization (WHO) and the United Nations Program on HIV/AIDS (UNAIDS) recommended the inclusion of male circumcision (MC) in HIV prevention programs, especially in countries with generalized heterosexual HIV epidemics, high HIV prevalence, and low prevalence of MC [1,2,3,4]
During sex if circumcised and reporting having no concerns regarding MC (Table 3). International agencies such as the WHO and UNAIDS recommend MC in HIV prevention programs for countries with low prevalence of MC, high rates of HIV infection, and epidemics driven by heterosexual sex, based on overwhelming evidence showing that MC can reduce heterosexual transmission by approximately 60% [1,5,6,7,8,9,40]
For Caribbean countries like Jamaica, in which MC is not traditionally performed [17], it is imperative to understand the attitude of individuals towards MC and the factors associated with acceptance to guide policy and program implementation

Summary

Introduction

In 2007, the World Health Organization (WHO) and the United Nations Program on HIV/AIDS (UNAIDS) recommended the inclusion of male circumcision (MC) in HIV prevention programs, especially in countries with generalized heterosexual HIV epidemics, high HIV prevalence, and low prevalence of MC [1,2,3,4]. This recommendation was based on epidemiological evidence which shows that MC is effective in reducing HIV acquisition by approximately 60% among males during heterosexual sex [1,5,6,7,8,9]. Countries are often faced with decisions regarding the inclusion of MC in their HIV prevention package as well as whether to offer MC to infants, adults, or both, in light of resource constraints, cultural and gender norms, and religious beliefs

Objectives

Results

Conclusion