title: Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC) among a Sample of Health Care Providers in Haiti.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  The 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%.
  
  
  CONCLUSIONS
  Participants 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.
authors.affiliation: AIDS Prevention Program, Florida International University, Miami, Florida, United States of America.
authors.forename: Jessy G
authors.initials: JG
authors.lastname: Dévieux
authors.affiliation: AIDS Prevention Program, Florida International University, Miami, Florida, United States of America.
authors.forename: Anshul
authors.initials: A
authors.lastname: Saxena
authors.affiliation: AIDS Prevention Program, Florida International University, Miami, Florida, United States of America.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Rosenberg
authors.affiliation: University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.affiliation: AIDS Prevention Program, Florida International University, Miami, Florida, United States of America.
authors.forename: Michèle
authors.initials: M
authors.lastname: Jean-Gilles
authors.affiliation: AIDS Prevention Program, Florida International University, Miami, Florida, United States of America.
authors.forename: Purnima
authors.initials: P
authors.lastname: Madhivanan
authors.affiliation: Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Gaston
authors.affiliation: AIDS Prevention Program, Florida International University, Miami, Florida, United States of America.
authors.forename: Muni
authors.initials: M
authors.lastname: Rubens
authors.affiliation: Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Harry
authors.initials: H
authors.lastname: Theodore
authors.affiliation: Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Marie-Marcelle
authors.initials: MM
authors.lastname: Deschamps
authors.affiliation: Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Serena P
authors.initials: SP
authors.lastname: Koenig
authors.affiliation: Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti; Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America.
authors.forename: Jean William
authors.initials: JW
authors.lastname: Pape
mesh_terms: D001291:Attitude of Health Personnel; D002944:Circumcision, Male; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006205:Haiti; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008297:Male