Uptake of early infant medical male circumcision as an HIV prevention intervention in Chongwe district, Zambia

Abstract

The World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF), 2016 recommended early infant male circumcision EIMC for prevention of HIV. Ministry of Health and other Non-Governmental organisations (NGO) such as CIDRZ are determined to reach male circumcision prevalence of 50% and uptake of 80% by the year 2020 through campaigns that help develop circumcision in the country. In Zambia, the national level of uptake of infant’s male circumcision is at 10% while in Chongwe District uptake is at 12%. Despite parents being sensitised about the importance and benefits of EIMC, uptake is still low. Using a cross sectional study design with a quantitative approach, a sample size of 352 women was used to identify factors that influence parents’ uptake of Early Infant Male Circumcision for HIV prevention among parents of new born infants in Chongwe District of Zambia. Results showed that slightly less than half (44.5%) of the sampled population had high knowledge levels on EIMC while 55.5% of the women had low knowledge levels. With regards to attitude towards EIMC, 64.5% of the sampled women had a positive attitude towards early infant male circumcision while only 34.5% had negative attitude. Slightly more than half (53.7%) of the women did not have their children circumcised while only 46.3 % were circumcised. Findings further suggested a significant relationship between EIMC uptake and the following variables; religious affiliation (p=0.020), number of male children a woman has (p=0.017), husband/partners circumcision status (p<0.001), attitude (p=0.015) and culture on male circumcision (p<0.001). Taking all factors into consideration and adjusting for possible confounding, three factors were found to be associated with EIMC uptake. Women with partners that were not circumcised were less likely to have their infants circumcised compared to women who had their partners circumcised (OR 0.10; 95% CI: 0.05 to 0.22).Women from cultures that practiced male circumcision were more than two and half times more likely to have their infants circumcised compared to women from cultures that did not practice male circumcision (OR = 2.8; 95% CI:1.65 to 5.00). Finally, women with a positive attitude towards EIMC had high odds of having their infants circumcised compared to women who had a negative attitude (OR = 2.7; 95% CI: 1.52 to 4.96). The study further shows that culture plays a critical role in influencing EIMC uptake in Chongwe District. Therefore, there is need to engage key traditional leaders in the mobilization process in order to increase uptake of EIMC in the district. Finally, the study established that women have low knowledge levels on EIMC.