title: Understanding the socio-economic and sexual behavioural correlates of male circumcision across eleven voluntary medical male circumcision priority countries in southeastern Africa.
abstract: BACKGROUND
  Male circumcision (MC) has been demonstrated to be effective and cost-effective for HIV/AIDS prevention. Global guidance to adopt this intervention was announced in 2007 for countries with high HIV/AIDS prevalence and low MC prevalence. However, scale up of voluntary medical male circumcision (VMMC) programs in MC priority countries have been slow. Many of these countries have particular cultural barriers that impede uptake of this effective intervention. This analysis explored correlates of MC status among men and their socio-economic, health and sexual behaviour factors using DHS data (2006-2011) from 11 MC priority countries.
  
  
  METHODS
  Our analysis included univariate unadjusted analyses for individual countries and the region (by combining all countries into one dataset) and a multiple logistic regression model.
  
  
  RESULTS
  Individual country results vary widely but alignment was mostly found between unadjusted analyses and multiple logistic regression model. The model found that men who are of the Muslim faith, reside in urban areas, have higher or secondary education attainment, hold professional occupations, and be in the richest wealth quintile are more likely to be circumcised. Circumcision is also positively correlated with lower reports of STIs, safe sexual behaviour, and HIV/AIDS prevention knowledge.
  
  
  CONCLUSIONS
  Since the data collected predate VMMC program launch in these countries, results can only indicate baseline associations. However, characteristics of these existing circumcision practices may be utilized for better population targeting and program management to achieve higher impact with this effective prevention strategy.
authors: Integrated Delivery, Global Development Program, Bill & Melinda Gates Foundation, Seattle, WA, USA. fionakylau@hotmail.com.
authors: Fiona K
authors: FK
authors: Lau
authors: Integrated Delivery, Global Development Program, Bill & Melinda Gates Foundation, Seattle, WA, USA. sylvia.jayakumar@gmail.com.
authors: Sylvia
authors: S
authors: Jayakumar
authors: Integrated Delivery, Global Development Program, Bill & Melinda Gates Foundation, Seattle, WA, USA. semasgaier@surgofoundation.org.|Department of Global Health, University of Washington, Seattle, WA, USA. semasgaier@surgofoundation.org.
authors: Sema K
authors: SK
authors: Sgaier
mesh_terms: D000293:Adolescent; D000328:Adult; D000351:Africa, Eastern / Q000453:epidemiology; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035141:Voluntary Programs; D055815:Young Adult