Women's knowledge and perception of male circumcision before and after its roll-out in the South African township of Orange Farm from community-based cross-sectional surveys.
The roll-out of medical male circumcision (MC) is progressing in Southern and Eastern Africa. Little is known about the effect of this roll-out on women. The objective of this study was to assess the knowledge and perceptions of women regarding MC in a setting before and after the roll-out. This study was conducted in the South African township of Orange Farm where MC prevalence among men increased from 17% to 53% in the period 2008-2010. Data from three community-based cross sectional surveys conducted in 2007, 2010 and 2012 among 1258, 1197 and 2583 adult women, respectively were studied. In 2012, among 2583 women, 73.7% reported a preference for circumcised partners, and 87.9% knew that circumcised men could become infected with HIV. A total of 95.8% preferred to have their male children circumcised. These three proportions increased significantly during the roll-out. In 2007, the corresponding values were 64.4%, 82.9% and 80.4%, respectively. Among 2581 women having had sexual intercourse with circumcised and uncircumcised men, a majority (55.8%, 1440/2581) agreed that it was easier for a circumcised man to use a condom, 20.5% (530/2581) disagreed; and 23.07 (611/2581) did not know. However, some women incorrectly stated that they were fully (32/2579; 1.2%; 95%CI: 0.9% to 1.7%) or partially (233/2579; 9.0%; 95%CI: 8.0% to 10.2%) protected when having unprotected sex with a circumcised HIV-positive partner. This study shows that the favorable perception of women and relatively correct knowledge regarding VMMC had increased during the roll-out of VMMC. When possible, women should participate in the promotion of VMMC although further effort should be made to improve their knowledge.
INSERM U1018, Villejuif, France.
Barbara
B
Maraux
Médecins sans Frontières, Paris, France.
Pascale
P
Lissouba
Progressus Research and Development, Johannesburg, South Africa.
Reathe
R
Rain-Taljaard
CHAPS, Parktown, Johannesburg, South Africa.
Dirk
D
Taljaard
Médecins du Monde, Paris, France.
Julie
J
Bouscaillou
Western Sydney Sexual Health Centre, Parramatta, Australia.|Marie Bashir Institute for Infectious Diseases and Biosecurity and Sydney Medical School-Westmead, University of Sydney, Sydney, Australia.
David
D
Lewis
Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.|University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.
Adrian
A
Puren
INSERM U1018, Villejuif, France.|AP-HP, Hôpital Ambroise Paré, Boulogne, France.|University of Versailles-Saint Quentin, Versailles, France.
Bertran
http://orcid.org/0000-0001-7849-8062
B
Auvert
D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D012725:Sexual Behavior; D012747:Sexual Partners; D013019:South Africa; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D014930:Women; D055815:Young Adult