Abstract
To compare different intervention models for promoting male circumcision (MC) to prevent HIV transmission in Western China. A total of 1690 male participants from multiple study sites were cluster randomly allocated to three-stage (Model A), two-stage (Model B), and one-stage (Model C) educational interventions. In all three interventions models, knowledge about MC significantly increased and the reported willingness to accept MC increased to 52.6% (255/485), 67.0% (353/527), and 45.5% (219/481) after intervention, respectively (P < 0.05). Rate of MC surgery uptake was highest (23.7%; 115/485) among those who received Model A intervention, compared to those who received Model B (17.1%; 90/527) or Model C (9.4%; 45/481) interventions (P < 0.05). Multivariable Cox regression analysis identified that Model A or Model B had twice the effect of Model C on MC uptake, with relative risks of 2.4 (95%CI, 1.5–3.8) and 2.2 (95%CI, 1.3–3.6), respectively. Model B was the most effective model for improving participants’ willingness to accept MC, while Model A was most successful at increasing uptake of MC surgery. Self-reported attitude towards MC uptake was not strongly correlated with actual behavior in this study focusing on the general male population in Western China.
Highlights
To battle this serious epidemic, a number of effective intervention strategies have been suggested, including male circumcision (MC)[9]
We developed a standardized questionnaire with four sub-sections: (1) demographic characteristics, (2) general knowledge about MC and HIV/AIDS, (3) willingness to accept MC and uptake MC surgery, and (4) reasons to accept or refuse MC
A total of 1690 participants participated in the interview and 1640 completed the whole interview (Completion rate: 97%)
Summary
To battle this serious epidemic, a number of effective intervention strategies have been suggested, including male circumcision (MC)[9]. Preliminary findings of our cross-sectional survey showed that the willingness of men in Western China to undergo circumcision was only 44.6%18. Increasing willingness and medical practice rates of MC is a major public health concern in Western China. No cohort studies have been conducted to assess the effectiveness of MC in preventing HIV infection among the general population in China[19]. To address this gap in knowledge, in the current study we compared three methods for improving the rates of MC acceptance and uptake among men in Western China
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