title: Acceptability and uptake of neonatal male circumcision in Lusaka, Zambia.
abstract: Neonatal male circumcision (NMC) is an uncommon procedure in Southern Africa, but is being scaled up in Zambia for long-term HIV prevention. We conducted a cross-sectional survey on NMC with a convenience sample of mothers of newborn boys at two public clinics in Lusaka. Following the survey, mothers received information on availability of NMC, and uptake of the service was tracked. Predictors of uptake were assessed using bivariate and multivariate logistic regression. Of the 1,249 eligible mothers approached, 1000 (80%) agreed to participate. Although 97% of surveyed mothers said they definitely or probably planned to have their newborn son circumcised, only 11% of participants brought their newborn sons for NMC. Significant predictors of uptake in adjusted models included: Older maternal age (AOR 3.77, 95% CI 1.48-9.63 for age 36 and above compared to mothers age 25 and below), having attended antenatal care at an NMC site (AOR 2.13, 95% CI 1.32-3.44), older paternal age (AOR 4.36, 95% CI 1.28-14.91 for age 26-35 compared to fathers age 25 and below), and the infant's father being circumcised (AOR 2.21, 95% CI 1.35-3.62). While acceptability studies in Southern Africa have suggested strong support for MC among parents for having their sons circumcised, this may not translate to high uptake of newly-introduced NMC services.
authors.affiliation: Centre for Infectious Disease Research in Zambia, CIDRZ, 5977 Benakale Road, Northmead, Lusaka, Zambia. wmemily@gmail.com
authors.forename: Emily
authors.initials: E
authors.lastname: Waters
authors.forename: Michelle
authors.initials: M
authors.lastname: Li
authors.forename: Bridget
authors.initials: B
authors.lastname: Mugisa
authors.forename: Kasonde
authors.initials: K
authors.lastname: Bowa
authors.forename: David
authors.initials: D
authors.lastname: Linyama
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stringer
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Stringer
mesh_terms: D000328:Adult; D002944:Circumcision, Male / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011181:Postnatal Care / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology