Page 104 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 2 of 9 Original Research

One of the potential challenges in adopting male circumcision circumcision, and a score from 7.79 to 10 indicated that the
in non-circumcising countries has been a lack of knowledge respondents had high knowledge about male circumcision.
regarding the benefits in reducing HIV transmission. 10,11,12,13 For modelling purposes, a dummy variable was created,
Studies on knowledge about male circumcision have been with 0 indicating respondents had low knowledge about
conducted previously, 10,11,14,15 some of which have found that male circumcision and 1 for those respondents who had high
the perception of risk of HIV infection is a predisposition for knowledge about male circumcision.
willingness to circumcise. 16,17,18,19,20 However, most of these
studies did not exclusively cover male youth age 15–35 years Perception of risk of HIV infection was created from responses
who reside in urban areas. to a direct question: ‘Do you think you are at risk of HIV
infection’? The responses were as follows: ‘Yes, at higher risk’
Little is known about the impact of sociodemographic (assigned a value of 3); ‘Yes, at low risk’ (assigned 2); ‘No, not
characteristics on knowledge about male circumcision and at risk at all’ (assigned 1).
perception of risk of HIV infection among youth in Zimbabwe
despite the fact that this is a key population in the fight Sociodemographic variables
against HIV. This study confines itself to youth aged 15–35 The respondents were asked about their age in completed
years, which is in line with the African Charter definition. 21
years, and these were categorised into 5-year age groups: 15–
Methods 19, 20–24, 25–29 and 30–35 years. Education was categorised
as primary, secondary and higher than secondary. Marital
Design, setting and sample status was categorised as never married, married or living
together, and never formerly married. Wealth status was
A cross-sectional study with a closed-ended questionnaire was measured using a household goods index, which was recoded
conducted in Harare among male youth. The sample was into low, medium and high wealth status. The measure was
calculated using Kish’s sample size determination. This derived from the presence of 10 household assets within the
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yielded a target population of 853 men aged 15–35 years. A total respondent’s household: generator, solar panel, radio,
of 783 youth were interviewed, yielding a response rate of 92%.
The study used the 2012 Zimbabwe Census as the sampling television, refrigerator, non-mobile telephone, computer,
frame, and a three-stage sampling design was employed. Firstly, washing machine, car and electricity connected to the dwelling
the process involved the selection of primary sampling units, unit. Employment status was classified into unemployed or
which were the Enumeration Areas (EAs). The second stage employed. Religion was categorised into mainline Christian,
involved the selection of households as secondary sampling Pentecostal, apostolic sect, other Christian and no religion,
units (SSUs). The last stage involved the selection of respondents while ethnicity was categorised into Shona or other.
within the households in the selected EAs. An eligible participant Respondents were also asked whether they had ever tested
was one male household member between the ages of 15 and 35 for HIV. The responses were ‘yes’ or ‘no’. Respondents were
years. When multiple households existed within a single asked whether they approved of voluntary counselling and
dwelling unit, a Kish grid was used to randomly select a testing (VCT) prior to circumcision (yes or no). Lastly,
responding household, and one member of the selected respondents were asked whether they had ever heard of
household was eligible to participate. If the selected household voluntary medical male circumcision (VMMC) (yes or no).
had no eligible respondent, the next household within the same
dwelling unit was selected. Thus, a Kish grid was used in the Data analysis
selection of a respondent in a multiple-respondent household Data management and statistical analyses were performed
and multiple-dwelling units. using SPSS version 22. The chi-square independence test was
used to compare the various sociodemographic and
Measures dependent variables. A binary logistic regression model
was used to identify predictors of knowledge about male
Dependent variables
circumcision. Multinomial logistic regression was used to
Knowledge about male circumcision was measured by 10 predict the net effect of the predictor variables (background
items measured at the nominal level. The responses for each characteristics) on perception of risk to HIV infection. In the
item were coded 0 and 1, with 0 indicating that an individual model, the reference category for the dependent variable was
did not have knowledge about that particular question and 1 ‘No, not at risk at all’.
indicating that an individual did have knowledge about it.
A knowledge score was obtained by summing up the Ethical consideration
individual knowledge questions. The score ranged from 0 to
10. The knowledge score was dichotomised. Previous studies Ethical clearance was granted by the relevant ethics council
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have also dichotomised knowledge scores in a similar way. (Ethics number: North-West University [NWU 00210-14-A9]
Studies have confirmed that dichotomisation of continuous and Medical Research Council of Zimbabwe [MRCZ/A/1848]).
variables makes interpretation easy and helps in simplifying A written informed consent was obtained from all the
analyses or presentation of results. 24,25 The dichotomisation study participants after describing the objectives of the study
was done at mean score (7.79). A value of 0–7.78 indicated to them. In addition, the respondents were assured of
that the respondents had low knowledge about male confidentially and anonymity.

http://www.sajhivmed.org.za 97 Open Access