Abstract
BackgroundHaiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC) has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti.MethodsA convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year.ResultsThe sample consisted of medical doctors (31.0%), nurses (49.0%), and other health care professionals (20.0%). Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15–5.71) times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing “the best age to perform MMC” as one year or older and having the mistaken belief that "MMC prevents HIV entirely" is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%.ConclusionParticipants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies with larger and more representative samples are needed to confirm this finding.
Highlights
Among the countries in Latin America and the Caribbean, Haiti has the second highest prevalence of HIV infection and the highest number of people living with HIV [1]
Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for male circumcision (MMC)
More than 90% of participants said that MMC would reduce sexually transmitted infections (STIs)
Summary
Among the countries in Latin America and the Caribbean, Haiti has the second highest prevalence of HIV infection and the highest number of people living with HIV [1]. According to the UNAIDS statistics, there are between 120,000 and 150,000 people living with HIV in Haiti, and the prevalence rate among adults between 15 and 49 years is 2.2%. Within the past few years, medical male circumcision (MMC) has been recommended by organizations such the World Health Organization (WHO) to help prevent the spread of HIV, in developing countries with traditionally low rates of male circumcision and generalized heterosexual epidemics [2]. Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC) has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti
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