P3.373 Male Circumcision Prevalence, Knowledge, Perceptions, and Intent Among Men in Bulawayo, Zimbabwe: A Cross-Sectional Study

Abstract

<h3>Background</h3> Zimbabwe has a target to reach 80% voluntary medical male circumcision (VMMC) coverage among HIV-negative 15–29 year-old men by 2015. This is a central strategy in the nation’s HIV response. Despite considerable recent investment, uptake has been slower than hoped. A cluster-randomised trial began in 2012 to assess the effectiveness of a sport-based VMMC demand-creation intervention. <h3>Methods</h3> At baseline, 663 men aged 18–45 years (median age 24 years) on 47 local soccer teams (both social and professional) in Bulawayo completed a self-administered questionnaire on VMMC-related knowledge, perceptions and intent using touchscreen mobile phones. Linear and logistic regressions were used to assess differences by age, educational attainment, and study group, adjusting for team-level clustering. <h3>Results</h3> 141 men (21.0%) reported being circumcised, the majority (80.6%) at a hospital or clinic and 24 (17.0%) within the last three months. Among the uncircumcised men, the majority (90.8%) knew that VMMC reduces HIV risk and thought that getting circumcised was a good idea (89.3%). About half (54.2%) correctly identified at least one local clinic providing VMMC services and 62.6% reported that they were planning to get circumcised. Among uncircumcised men, those with A-level/higher education had better VMMC knowledge (AOR = 3.15, 95% CI = 1.52–6.53), but were less likely to intend to become circumcised (AOR = 0.57, 95% CI = 0.37–0.89). Being circumcised was weakly associated with having A-Level/higher education (AOR = 1.52, 95% CI = 0.95–2.43). No differences were observed between study groups in reported circumcision status, age, education, VMMC knowledge, or VMMC intention. <h3>Conclusion</h3> This study provides evidence that VMMC-related knowledge and intentions are high amongst uncircumcised, soccer-playing men in Bulawayo, though VMMC coverage remains far below 80%. Effective demand creation interventions are needed and should ensure uncircumcised men are aware of local sites offering VMMC services. Further research should investigate barriers to VMMC uptake among men in Bulawayo.