Factors influencing circumcision of young males in Harare, Zimbabwe
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This thesis is a study of the factors influencing young male circumcision in Harare, Zimbabwe utilising an explanatory sequential mixed method research approach to examine the factors. The study used cross-sectional data on 784 men, 26 in-depth interviews with the study population and 6 in-depth interviews with key informants (opinion leaders) collected in 2014. The quantitative data sought to examine factors influencing male circumcision and willingness to circumcise among men aged 15-35, utilising various data analysis techniques such as frequencies, binary logistic regression and multinomial logistic regression to achieve the objectives of the study. The qualitative data built on the quantitative results, which sought to provide a deeper understanding of the myths and perceptions surrounding male circumcision uptake and willingness to circumcise, using the thematic analysis approach. Respondents who had tested for HIV were less likely (OR=0.13, p<0.05) to be circumcised compared to those who never tested. There was a positive significant relationship between knowledge about male circumcision and male circumcision status. With respect to attitudes, men who indicated that they had favourable attitude towards male circumcision were more likely (OR, 2.79, p<0.05) to be circumcised. In addition, the study found that, there was a negative association between age and willingness to circumcise. Specifically, youth aged 25-29 were less likely (OR, 0.91, p<.0.1) to be willing to circumcise compared to those aged 30-35. Youth who reported to have attained primary education were less likely (OR=0.395, p<0.05) to be willing to circumcise compared to those aged 30-35. Additionally, youth who indicated that they had secondary education were (OR=0.581, p<0.05) less likely to be willing to circumcise. Respondents who belonged to the Apostolic sect were more likely (OR, 2.78, p<0.05) to be willing to circumcise than respondents who belonged to No religion. Furthermore, perception of risk to HIV infection was significantly related to willingness to circumcise. Respondents who perceived themselves to be at a higher risk to HIV infection were less likely (OR=0.573, p<0.1) to be willing to circumcise compared to those who perceived themselves to be at no risk. Moreover, the findings showed that young men who had favourable attitudes towards male circumcision were more likely (OR, 3.29, p<0.05) to report willingness to circumcise compared to those who had unfavourable attitude. Knowledge of male circumcision was not significantly related to willingness to circumcise. The qualitative results revealed that perceptions and myths surrounding male circumcision were widespread and they either inhibit or promote male circumcision uptake or willingness to circumcise. For instance, myths surrounding foreskin disposal, perceived fear of HIV testing, perceived adverse effects and perceived effect of circumcision on sexual pleasure impacted on uptake of male circumcision. There was also the recognition that respondents had incomplete knowledge about male circumcision and it partial prevention of HIV infection. The study’s findings highlight the need to promote HIV health education, which would emphasise the health benefits of male circumcision and deliver correct messages about the partial protective effects of male circumcision against HIV infection. In addition, there is the need to run programmes that would demystify perceptions and myths surrounding male circumcision in the communities.
- Humanities