title: "If You Are Not Circumcised, I Cannot Say Yes": The Role of Women in Promoting the Uptake of Voluntary Medical Male Circumcision in Tanzania.
abstract: Voluntary Medical Male Circumcision (VMMC) for HIV prevention in Tanzania was introduced by the Ministry of Health and Social Welfare in 2010 as part of the national HIV prevention strategy. A qualitative study was conducted prior to a cluster randomized trial which tested effective strategies to increase VMMC up take among men aged ≥20 years. During the formative qualitative study, we conducted in-depth interviews with circumcised males (n = 14), uncircumcised males (n = 16), and participatory group discussions (n = 20) with men and women aged 20-49 years in Njombe and Tabora regions of Tanzania. Participants reported that mothers and female partners have an important influence on men's decisions to seek VMMC both directly by denying sex, and indirectly through discussion, advice and providing information on VMMC to uncircumcised partners and sons. Our findings suggest that in Tanzania and potentially other settings, an expanded role for women in VMMC communication strategies could increase adult male uptake of VMMC services.
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: Haika
authors.initials: H
authors.lastname: Osaki
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: Gerry
authors.initials: G
authors.lastname: Mshana
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: Mwita
authors.initials: M
authors.lastname: Wambura
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Grund
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: Nyasule
authors.initials: N
authors.lastname: Neke
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: Evodius
authors.initials: E
authors.lastname: Kuringe
authors.affiliation: Jhpiego-an affiliate of John Hopkins University, Dar-es-Salaam, Tanzania.
authors.forename: Marya
authors.initials: M
authors.lastname: Plotkin
authors.affiliation: Jhpiego-an affiliate of John Hopkins University, Dar-es-Salaam, Tanzania.
authors.forename: Hally
authors.initials: H
authors.lastname: Mahler
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Fern
authors.initials: F
authors.lastname: Terris-Prestholt
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Weiss
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
mesh_terms: D000328:Adult; D002944:Circumcision, Male; D005260:Female; D006268:Health Facilities; D006801:Humans; D008297:Male; D008875:Middle Aged; D013636:Tanzania; D014930:Women; D055815:Young Adult