MAKING A DIFFERENCE IN PEOPLE'S LIVES

16th ICASA CONFERENCE 

4-8th December Millennium Hall, Addis Ababa-Ethiopia

Attitudes and Acceptability of Male Circumcision: One Year after Launch of the

National Male Circumcision Policy in Uganda

Presenter: Robert NangaiCo-authors: Esther Kaggwa, Simon Ndizeye, Cheryl Lettenmaier, Ruth

Museruka

Health Communication Partnership

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Overview

• 1.2 million Ugandans living with HIV• Over 130,000 new infections every year• MC reduces the risk of HIV infection by 60% • 25% of Ugandans currently circumcised • Circumcising 4.2 million men in 5 years can avert

400,000 new infections• Limited locations where MMC is available

MAKING A DIFFERENCE IN PEOPLE'S LIVES

MMC Communication 2008 - 2010

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Study Methodology

• Household survey in 31 districts• November – December, 2010• Interviewed 2,896 individuals aged 15-54 years• Multi stage stratified sampling for young people

aged 15-24 and adults 25-54• Objectives:

To evaluate the reach and effects of HCP supported communication activities

To provide baseline measures for new communication activities

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Respondent CharacteristicsCharacteristics Number Percentage

No. of respondents 2,896

MaleFemale

1,3791,517

4852

15-2425-49

1,4831,413

5149

RuralUrban

2,174722

7525

Non-circumcising culture

2,200 77

• 61% were aware of Uganda MC Policy• 21% of males had been circumcised (84% circumcised as babies)• 42% reported that their community approves of MC

MAKING A DIFFERENCE IN PEOPLE'S LIVES

• 45% exposed• Males from

urban areas with secondary of higher education more likely to be exposed

Exposure to MMC Messages

52

38 41

57

38

5445

010203040506070

Percent

N = 2896All P < 0.05

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Knowledge of a Place Offering Medical Male Circumcision Services

3238

30

52

26

51 47

25

36

0102030405060

Percent

N = 2,795All P < 0.05

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Percent of Men & Women who Said Male Circumcision is Harmful

20

10

6

3

0 5 10 15 20 25 30

May lead one tocontract HIV

Reduces penis size

Reduces sexual urge

Affects the ability tobare children

Percent

N = 1275

• 29% thought MC is harmful

• Rural, aged 15-17 years, lower SES, & primary or lower education more likely to say MC is harmful

n = 402

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Percent of Men & Women who Said Male Circumcision is Beneficial

3

46

61

0

10

20

30

40

50

60

70

Reduces chances ofcontracting HIV

Reduces chances ofcontracting other

STIs

Reduces worryduring sex

Pe

rce

nt

N = 1275

73% said MC is beneficial

N = 2,082

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Variable Odds ratioEducation levelPrimary and below (ref) 1Secondary and above 1.6

Exposure to MC messages Not exposed to MC messages (ref) 1Exposed to MC messages 3.8Age25-49 years (ref) 115-24 years 2.6Others Marital status** 1.23Residence** 0.86Sexual activity** 1.17

**Not associated with intention to circumcise

Factors Associated with Intention to Circumcise (Multivariate)

N = 1,041

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Conclusions & Recommendations

• Knowledge of a place offering MMC low

• High level of acceptance for MMC

• Exposure to MMC messages strongly associated with intention to circumcise

• Married, older men significantly less likely to intend to circumcise

• MMC communication should focus on older married men & identify services

MAKING A DIFFERENCE IN PEOPLE'S LIVES

Acknowledgements

• Ministry of Health

• MC Working Group

• HCP

• MUSPH

• USAID