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“Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania

BACKGROUND: In 2009, the Government of Tanzania embarked on scaling up voluntary medical male circumcision (VMMC) services for HIV prevention in 8 priority regions, with the aim of serving 2.8 million boys and men ages 10–34 years by 2013. By mid-2012, more than 110,000 boys and men in Iringa and Nj...

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Autores principales: Plotkin, Marya, Castor, Delivette, Mziray, Hawa, Küver, Jan, Mpuya, Ezekiel, Luvanda, Paul James, Hellar, Augustino, Curran, Kelly, Lukobo-Durell, Mainza, Ashengo, Tigistu Adamu, Mahler, Hally
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Global Health: Science and Practice 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168557/
https://www.ncbi.nlm.nih.gov/pubmed/25276521
http://dx.doi.org/10.9745/GHSP-D-12-00037
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author Plotkin, Marya
Castor, Delivette
Mziray, Hawa
Küver, Jan
Mpuya, Ezekiel
Luvanda, Paul James
Hellar, Augustino
Curran, Kelly
Lukobo-Durell, Mainza
Ashengo, Tigistu Adamu
Mahler, Hally
author_facet Plotkin, Marya
Castor, Delivette
Mziray, Hawa
Küver, Jan
Mpuya, Ezekiel
Luvanda, Paul James
Hellar, Augustino
Curran, Kelly
Lukobo-Durell, Mainza
Ashengo, Tigistu Adamu
Mahler, Hally
author_sort Plotkin, Marya
collection PubMed
description BACKGROUND: In 2009, the Government of Tanzania embarked on scaling up voluntary medical male circumcision (VMMC) services for HIV prevention in 8 priority regions, with the aim of serving 2.8 million boys and men ages 10–34 years by 2013. By mid-2012, more than 110,000 boys and men in Iringa and Njombe regions had received VMMC. The majority (85%) of these VMMC clients were under 19 years old (average age, 16 years). This study aimed to identify potential barriers and facilitators to VMMC among older men. METHODS: We conducted 16 focus group discussions, stratified by sex and age, with 142 purposefully selected participants in 3 districts of Iringa and Njombe regions. RESULTS: Both men and women generally had positive attitudes toward VMMC. Social and personal barriers to obtaining VMMC among adult men included shame associated with seeking services co-located with younger boys and perceived inappropriateness of VMMC after puberty, particularly after marriage and after having children. Additional barriers included concerns about partner infidelity during the post-surgical abstinence period, loss of income, and fear of pain associated with post-surgical erections. Facilitators included awareness of the HIV-prevention benefit and perceptions of cleanliness and enhanced attractiveness to women. CONCLUSIONS: While men and women in Iringa and Njombe regions in Tanzania generally view VMMC as a desirable procedure, program implementers need to address barriers to VMMC services among adult men. Selected service delivery sites in the Iringa and Njombe regions will be segregated by age to provide services that are “friendly” to adult men. Services will be complemented with behavior change communication initiatives to address concerns of older men, encourage women’s support for circumcision and adherence to the post-surgical abstinence period, and change social norms that inhibit older men from seeking circumcision.
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spelling pubmed-41685572014-09-30 “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania Plotkin, Marya Castor, Delivette Mziray, Hawa Küver, Jan Mpuya, Ezekiel Luvanda, Paul James Hellar, Augustino Curran, Kelly Lukobo-Durell, Mainza Ashengo, Tigistu Adamu Mahler, Hally Glob Health Sci Pract Original Articles BACKGROUND: In 2009, the Government of Tanzania embarked on scaling up voluntary medical male circumcision (VMMC) services for HIV prevention in 8 priority regions, with the aim of serving 2.8 million boys and men ages 10–34 years by 2013. By mid-2012, more than 110,000 boys and men in Iringa and Njombe regions had received VMMC. The majority (85%) of these VMMC clients were under 19 years old (average age, 16 years). This study aimed to identify potential barriers and facilitators to VMMC among older men. METHODS: We conducted 16 focus group discussions, stratified by sex and age, with 142 purposefully selected participants in 3 districts of Iringa and Njombe regions. RESULTS: Both men and women generally had positive attitudes toward VMMC. Social and personal barriers to obtaining VMMC among adult men included shame associated with seeking services co-located with younger boys and perceived inappropriateness of VMMC after puberty, particularly after marriage and after having children. Additional barriers included concerns about partner infidelity during the post-surgical abstinence period, loss of income, and fear of pain associated with post-surgical erections. Facilitators included awareness of the HIV-prevention benefit and perceptions of cleanliness and enhanced attractiveness to women. CONCLUSIONS: While men and women in Iringa and Njombe regions in Tanzania generally view VMMC as a desirable procedure, program implementers need to address barriers to VMMC services among adult men. Selected service delivery sites in the Iringa and Njombe regions will be segregated by age to provide services that are “friendly” to adult men. Services will be complemented with behavior change communication initiatives to address concerns of older men, encourage women’s support for circumcision and adherence to the post-surgical abstinence period, and change social norms that inhibit older men from seeking circumcision. Global Health: Science and Practice 2013-03-21 /pmc/articles/PMC4168557/ /pubmed/25276521 http://dx.doi.org/10.9745/GHSP-D-12-00037 Text en © Plotkin et al. http://creativecommons.org/licenses/by/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/
spellingShingle Original Articles
Plotkin, Marya
Castor, Delivette
Mziray, Hawa
Küver, Jan
Mpuya, Ezekiel
Luvanda, Paul James
Hellar, Augustino
Curran, Kelly
Lukobo-Durell, Mainza
Ashengo, Tigistu Adamu
Mahler, Hally
“Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania
title “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania
title_full “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania
title_fullStr “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania
title_full_unstemmed “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania
title_short “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania
title_sort “man, what took you so long?” social and individual factors affecting adult attendance at voluntary medical male circumcision services in tanzania
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168557/
https://www.ncbi.nlm.nih.gov/pubmed/25276521
http://dx.doi.org/10.9745/GHSP-D-12-00037
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