Factors associated with uptake of voluntary medical male circumcision, Mazowe District, Zimbabwe, 2014.
BACKGROUND
Voluntary Medical Male Circumcision (VMMC) is the surgical removal of the foreskin by a trained health worker. VMMC was introduced in Zimbabwe in 2009. It is of concern that the programme performance has been below expectations nationally and in Mazowe district. Zimbabwe is unlikely to meet its 2015 target of circumcising 1 200 000 men aged between 15 and 29 years and unlikely to enjoy maximum benefits of VMMC which include prevention of HIV, sexually transmitted infections and cervical cancer. We therefore broadly aimed at identifying factors influencing the level of VMMC uptake in Mazowe district.


METHODS
An analytic cross-sectional study was carried out in Mazowe district. A multi-stage probability sampling strategy was used to select 300 men aged between 18 and 49 years. Pretested interviewer administered questionnaires, key informant interviews and focus group discussions were used to collect data. Quantitative data was analysed using Epi info where odds ratios and p-values were calculated. Qualitative data was analysed thematically.


RESULTS
Being of Shona origin (AOR= 7.69 (95%CI 1.78-33.20)), fear of pain (AOR= 7.09 (95%CI 2.58-19.47)) and fear of poor wound healing (AOR= 2.68 (95%CI 1.01-7.08)) were independently associated with being uncircumcised while having a circumcised friend and encouragement by a friend or relative were independently associated with being circumcised.


CONCLUSIONS
Fear of pain, fear of poor wound healing and encouragement by a friend or relative were associated with circumcision status. Widening use of surgical devices and third part referrals may assist in scaling up the programme.
Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe.
Maxwell
M
Rupfutse
Ministry of Health and Child Care Mashonaland Central Province Medical Directorate, Zimbabwe.
Cremence
C
Tshuma
Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe.
Mufuta
M
Tshimanga
Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe.
Notion
N
Gombe
Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe.
Donewell
D
Bangure
Department of Community Medicine, University of Zimbabwe, Harare 00263, Zimbabwe.
Maureen
M
Wellington
D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005239:Fear / Q000523:psychology; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D012959:Socioeconomic Factors; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
HIV; Male circumcision; Mazowe district; Zimbabwe