Acceptability of medical male circumcision among uncircumcised young men at Mansa College of Education, Zambia : influence of perceptions about effects on male sexuality

Mlewa, Andrew Josephat (2013-03)

Thesis (MPhil)--Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: Research focus: Voluntary Medical Male Circumcision (VMMC) is one of the top priority interventions for HIV prevention in Zambia. However, the country is struggling with scale-up of this intervention. New insights into factors that facilitate or impede its acceptability in non-circumcising communities are urgently needed, including the influence of perceptions about effects of circumcision on sexuality. Research methods: To gain new insights into these factors 24 uncircumcised young men and seven young women were recruited to participate in the study. Using ten In-depth interviews and three focus group discussions, the study examined perceptions about effects of MMC on male sexuality and the influence on acceptability of the procedure. Results/findings: Despite doubts about its efficacy, the research found overwhelming support among uncircumcised men for circumcision as a tool for preventing HIV. The study also found that uncircumcised men have specific perceptions and concerns about how male circumcision positively or negatively affects sexual function/performance and pleasure in men and for women. These perceptions were found to be important considerations for accepting circumcision among the majority of male respondents. Circumcision preference among female respondents was because of the perception that it protects men against HIV and women against cervical cancer. Main conclusions and recommendations: There was overwhelming support for male circumcision among uncircumcised men in the study, majority of who consider protection against HIV as the most important reason for accepting the procedure. More than half of the male respondents saw it as important for enhancing sexual performance and sexual pleasure for themselves and their sexual partners. Key recommendations include: development of effective community-based demand generation strategies that include use of multiple channels that address the main barriers to acceptability; conduct further research on facilitators of MMC acceptability; conduct research on effects of circumcision on male sexuality, risk compensation and sexual disinhibit ion among circumcised men. These measures will contribute to the design of more effective Information Education Communication (IEC) strategies and activities.

AFRIKAANSE OPSOMMING: Navorsingsfokus: Vrywillige mediese manlike besnydenis (VMMB) is een van die hoofprioriteitsintervensies vir MIV-voorkoming in Zambië. Tog sukkel die land om hierdie intervensie uit te brei. Daar is dus ’n dringende behoefte aan nuwe insig in die faktore wat bepaal hoe maklik of moeilik gemeenskappe wat nié aan besnydenis glo nie, die intervensie sal aanvaar. Dít sluit in die invloed van opvattings oor die effek van besnydenis op seksualiteit. Navorsingsmetode: Om nuwe insig in hierdie faktore te verkry, is 24 onbesnyde jong mans en sewe jong vroue gewerf om aan die studie deel te neem. Met behulp van tien diepteonderhoude en drie fokusgroepbesprekings het die studie ondersoek ingestel na die opvattings oor die effek van MMB op manlike seksualiteit, en in watter mate dit die aanvaarbaarheid van die prosedure beïnvloed. Resultate/bevindinge: Ondanks twyfel oor die doeltreffendheid van die prosedure, dui die navorsing daarop dat onbesnyde mans oorweldigend ten gunste is van besnydenis as instrument om MIV te voorkom. Die studie bevind ook dat onbesnyde mans bepaalde opvattings het oor die hetsy positiewe of negatiewe uitwerkings van manlike besnydenis op seksuele funksionering/prestasie en genot vir mans sowel as vroue. Vir die meeste manlike respondente blyk hierdie opvattings belangrike oorwegings te wees in die aanvaarding van besnydenis. Vrouerespondente se voorkeur vir besnydenis kan toegeskryf word aan die opvatting dat dit mans teen MIV en vroue teen servikskanker beskerm. Hoofgevolgtrekkings en -aanbevelings: Die onbesnyde mans in die studie is oorweldigend ten gunste van manlike besnydenis. Die meeste van hulle beskou beskerming teen MIV as die belangrikste rede om die prosedure te aanvaar. Meer as die helfte van die manlike respondente reken ook besnydenis is belangrik om seksuele prestasie en genot vir hulself sowel as hul bedmaats te verhoog. Hoofaanbevelings sluit in die ontwikkeling van doeltreffende gemeenskapsgebaseerde vraagverhogingstrategieë, wat onder meer van verskeie kanale gebruik maak om die hoofversperrings vir aanvaarbaarheid uit die weg te ruim; verdere navorsing oor faktore wat MMB-aanvaarbaarheid fasiliteer, sowel as navorsing oor die effek van besnydenis op manlike seksualiteit, risiko-kompensasie en seksuele disinhibisie onder besnyde mans. Inligting hieroor sal bydra tot die ontwerp van doeltreffender inligting-en-opvoedingstrategieë en -aktiwiteite.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/80005
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