1. Adult male circumcision as an intervention against HIV: An operational study of uptake in a South African community (ANRS 12126)
- Author
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Beverley Singh, Veerle Dermaux-Msimang, David A. Lewis, Bertran Auvert, Camille Legeai, Dino Rech, Adrian Puren, Pascale Lissouba, Dirk Taljaard, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Progressus, National Institute for Communicable Diseases [Johannesburg] (NICD), University of the Witwatersrand [Johannesburg] (WITS), Hôpital Ambroise Paré [AP-HP], Funding for this work was provided by ANRS-12126 grant (France), NICD (South Africa), INSERM (France), SACEMA (South Africa), and USAID Small grant award GHH-I-02-07-00032-00., BMC, Ed., and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Program evaluation ,musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Adult male ,Adolescent ,Cross-sectional study ,Population ,Psychological intervention ,foreskin ,HIV Infections ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,South Africa ,Young Adult ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Intervention (counseling) ,acceptability ,Surveys and Questionnaires ,medicine ,male circumcision ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Young adult ,education ,HIV-AIDS ,Gynecology ,education.field_of_study ,030505 public health ,business.industry ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,3. Good health ,Infectious Diseases ,Cross-Sectional Studies ,Circumcision, Male ,uptake ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,0305 other medical science ,business ,Demography ,Research Article - Abstract
Background To evaluate the knowledge, attitudes and beliefs about adult male circumcision (AMC), assess the association of AMC with HIV incidence and prevalence, and estimate AMC uptake in a Southern African community. Methods A cross-sectional biomedical survey (ANRS-12126) conducted in 2007-2008 among a random sample of 1198 men aged 15 to 49 from Orange Farm (South Africa). Face-to-face interviews were conducted by structured questionnaire. Recent HIV infections were evaluated using the BED incidence assay. Circumcision status was self-reported and clinically assessed. Adjusted HIV incidence rate ratios (aIRR) and prevalence ratios (aPR) were calculated using Poisson regression. Results The response rate was 73.9%. Most respondents agreed that circumcised men could become HIV infected and needed to use condoms, although 19.3% (95%CI: 17.1% to 21.6%) asserted that AMC protected fully against HIV. Among self-reported circumcised men, 44.9% (95%CI: 39.6% to 50.3%) had intact foreskins. Men without foreskins had lower HIV incidence and prevalence than men with foreskins (aIRR = 0.35; 95%CI: 0.14 to 0.88; aPR = 0.45, 95%CI: 0.26 to 0.79). No significant difference was found between self-reported circumcised men with foreskins and other uncircumcised men. Intention to undergo AMC was associated with ethnic group and partner and family support of AMC. Uptake of AMC was 58.8% (95%CI: 55.4% to 62.0%). Conclusions AMC uptake in this community is high but communication and counseling should emphasize what clinical AMC is and its effect on HIV acquisition. These findings suggest that AMC roll-out is promising but requires careful implementation strategies to be successful against the African HIV epidemic.
- Published
- 2011
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