Page 141 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 7 Original Research

A cross-sectional study of the factors associated

with male circumcision status among college youth

in Ndola, Zambia, 2016

Authors: Background: New cases of HIV are increasing among young adults in Zambia; yet voluntary
Ernest Kateule medical male circumcision (VMMC) coverage as an HIV prevention measure remains low.
1,2
Ramya Kumar 3
David Mwakazanga 2 Despite having the highest HIV burden in the province, Ndola district had a VMMC coverage
Modest Mulenga 2 of 23% in 2015 compared to the national target of 80% among high-risk groups.
Victor Daka 2
Gershom Chongwe Objectives: To determine predictive factors associated with circumcision status among male
4
students in Ndola district.
Affiliations:
1 Zambia Field Epidemiology Methods: We conducted a cross-sectional study in May 2016 among students aged 18–35 years
Training Program, Ministry enrolled in five conveniently sampled colleges. We administered a structured questionnaire to
of Health, Lusaka, Zambia
assess the knowledge, attitudes and perceptions about VMMC. We used multivariable logistic
regression to determine factors associated with male circumcision (MC) status.
2 Tropical Diseases Research
Centre, Ndola, Zambia Results: Of 136 students interviewed, 63% were circumcised, and of those, 96% were medically
circumcised. Half of all students were aged 21–24 years. Those who perceived the circumcision
3 Zambia AIDS Related
Tuberculosis Projects, procedure to be ‘safe’ (adjusted odds ratio [aOR] = 5.13; 95% CI: 2.09–14.82), and knew that it
Lusaka, Zambia reduced female to male HIV transmission risk (aOR = 3.65; 95% CI: 3.12–11.67), were more
likely to be circumcised. The perception that MC promotes ‘promiscuous behaviour’ (aOR =
4 School of Public Health, 0.20; 95% CI: 0.07–0.61), and that sexual sensitivity is the ‘same’ regardless of circumcision
University of Zambia, status, were associated with not being circumcised (aOR = 0.13; 95% CI: 0.02–0.80).
Lusaka, Zambia
Conclusion: Students had adequate knowledge about the safety of medical circumcision,
Corresponding author:
Ernest Kateule and the subsequent risk reduction of HIV infection. Interventions aimed at addressing
[email protected] negative sexual perceptions about circumcision may increase VMMC coverage among
college students.
Dates:
Received: 01 Feb. 2019 Keywords: College students; Ethnicity; HIV; Voluntary medical male circumcision; Ndola;
Accepted: 05 Apr. 2019 Zambia.
Published: 20 June 2019
How to cite this article:
Kateule E, Kumar R, Introduction
Mwakazanga D, et al.
A cross-sectional study of In Zambia, HIV prevalence remains high, with a prevalence of 12.3% and an overall HIV annual
1
the factors associated with incidence among men and women aged 15–49 years of 70 per 10 000 population. In an effort to
male circumcision status combat the high HIV burden, Zambia initiated programmes to expand the provision of voluntary
among college youth in medical male circumcision (VMMC) in 2007. This policy change was based on evidence from three
2
Ndola, Zambia, 2016. S Afr J
HIV Med. 2019;20(1), a952. randomised controlled trials conducted in Kenya, Uganda and South Africa, which showed that
https://doi.org/10.4102/ male circumcision (MC) reduced the risk of sexual transmission of HIV from women to men by
sajhivmed.v20i1.952 approximately 60%. An assessment of the potential impact and costs of scaling-up MC in Zambia
3
found that if the government had expanded MC coverage to 80% of all adolescent and adult males
Copyright:
© 2019. The Authors. by 2015, it would have averted an estimated 486 000 new HIV infections (approximately 50% of all
Licensee: AOSIS. This work new infections) and would result in substantial cumulative net savings for the public health sector.
is licensed under the For these reasons, a national programme to make high-quality and safe MC services available and
Creative Commons accessible on a voluntary basis to all HIV-negative men aged 15–49 years was implemented. 4
Attribution License.
Zambia had set an ambitious target of scaling-up VMMC programmes to achieve 80% VMMC
5
coverage by December 2015. Although there had been significant progress in scaling up high-
Read online: impact HIV preventive interventions, Zambia fell short of the VMMC coverage goal. The country
Read online:
Scan this QR only managed to circumcise 1 005 424 out of eligible 1 864 396 men during 2012–2015, thus
Scan this QR
code with your
code with your 4
smart phone or
smart phone or achieving a national VMMC coverage of 54%, instead of the 80% target. Nevertheless, the
mobile device
mobile device new 2016–2020 VMMC operational plan is built on the existing momentum and aims to reach
to read online.
to read online.
an ambitious target of 90% coverage of men aged 10–49 years, with a focus on those aged
http://www.sajhivmed.org.za 134 Open Access