Uptake and perceptions of voluntary medical male circumcision among HIV-negative men in serodiscordant relationships in Zambia (2012-2015)

PLoS One. 2024 Nov 8;19(11):e0309295. doi: 10.1371/journal.pone.0309295. eCollection 2024.

Abstract

Voluntary medical male circumcision (VMMC) is a recommended HIV prevention strategy that few studies have promoted to HIV-negative men in serodiscordant relationships. We conducted a cross-sectional study on uptake and perceptions of VMMC among serodiscordant couples between 2012 and 2015. Heterosexual couples attending couples voluntary counselling and testing for HIV who had discordant results (M-, F+) were referred for VMMC. At least one month after counselling and referral, 343 men were surveyed on uptake and perceptions of VMMC. A subset of 134 uncircumcised men responded to another survey assessing their intention to uptake VMMC and reasons for not getting circumcised. Forty percent (n = 62) of men eligible for VMMC either up took (n = 22) or planned to uptake circumcision (n = 40). The most cited reasons for not getting circumcised were the inability to get time off work (34%) and culture/traditions (26%). These findings support integrated approaches, pairing evidence-based HIV prevention interventions such as couples voluntary counselling and testing with VMMC, and targeting men at highest risk for HIV. Additional counselling may be needed for couples whose cultural backgrounds do not support VMMC.

MeSH terms

  • Adult
  • Circumcision, Male* / psychology
  • Counseling
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • HIV Infections* / psychology
  • HIV Seronegativity
  • Humans
  • Male
  • Middle Aged
  • Perception
  • Sexual Partners / psychology
  • Young Adult
  • Zambia / epidemiology

Grants and funding

This study was supported by the International AIDS Vaccine Initiative (IAVI) with the generous support of the American people through the United States Agency for International Development (USAID, https://www.usaid.gov/). A full list of IAVI donors can be found at https://www.iavi.org/; National Institutes of Health (https://www.nih.gov/) grants (R01 MH66767, R01 HD40125, and R01 HD40125; R01 AI051231); the AIDS International Training and Research Program Fogarty International Center (D43 TW001042); and the Emory Center for AIDS Research (P30 AI050409). Additional support was provided from the Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD R01 HD40125). The contents of this manuscript are the responsibility of the authors and do not necessarily reflect the views of USAID or the US Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.