Factors leading to the low uptake of voluntary medical male circumcision in an urban setup: A case of Chitungwiza (Zengeza 2, 3 and 4).

Abstract

Voluntary Medical Male Circumcision in Zimbabwe is moving at a slow pace. Men are reluctant to get circumcised despite the fact that it reduces the chances of HIV infection. Due to high HIV prevalence rates in Zimbabwe, it is important to increase uptake of VMMC so as to prevent the spread of HIV. This study sought to investigate the factors leading to low uptake of VMMC in Zengeza 2, 3 and 4 in Chitungwiza. A triangulation of both quantitative and qualitative data collection methods was used. A total of 300 questionnaires were administered among men aged 13-49 years. Four FGDs were conducted among men aged 13-49 years, and three FGDs were conducted with married women aged 15-49 years. The study also conducted four in-depth interviews with circumcised men and three key informant interviews. Data was analysed and captured using SPSS Version 21. The findings show that 16% of the men were circumcised. The majority of the respondents were aware of VMMC and they demonstrated good knowledge about male circumcision. The respondents reported that they were circumcised because they wanted to prevent HIV/STIs, improve penile hygiene, as well as peer and cultural influence. More than a third of the men were circumcised by a health worker. The majority made the decision themselves to get circumcised. The majority of uncircumcised men were not willing to get circumcised due to fear of surgical complications, pain, old age, reduced sexual pleasure, long period of abstinence from sexual activities and myths and misconceptions. The majority of the respondents had knowledge about the benefits of circumcision. They were also knowledgeable about the problems of circumcision such as pain and delayed wound healing. Almost half of the respondents heard about VMMC from the media, and most men knew where the circumcision procedure was performed. The majority of the men agreed that circumcision reduces the chances of contracting HIV/STIs and that men should use condoms after circumcision. The respondents were aware of the Pre-Pex device, although most of the respondents did not know its advantages. Men believed that circumcision affected sensitivity of the tip of the male penis. Negative attitudes were all shown on HIV testing before circumcision. Despite having knowledge about benefits of male circumcision, men were not willing to get circumcised. The study recommends increasing IEC on male circumcision, also to continue with the expansion of circumcision in schools by PSI Zimbabwe and VMMC programmes targeting parents.