Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Factors associated with married women’s support of male circumcision for HIV prevention in Uganda: a population based cross–sectional study

Authors: Komi Mati, Korede K. Adegoke, Hamisu M. Salihu

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Despite the protective effect of male circumcision (MC) against HIV in men, the acceptance of voluntary MC in priority countries for MC scale–up such as Uganda remains limited. This study examined the role of women’s sociodemographic characteristics, knowledge of HIV and sexual bargaining power as determinants of women’s support of male circumcision (MC).

Methods

Data from the Uganda AIDS Indicator Survey, 2011 were analyzed (n = 4,874). Bivariate and multivariate logistic regression analyses with random intercept were conducted to identify factors that influence women’s support of MC.

Results

Overall, 67.0 % (n = 3,276) of the women in our sample were in support of MC but only 28.0 % had circumcised partners. Women who had the knowledge that circumcision reduces HIV risk were about 6 times as likely to support MC than women who lacked that knowledge [AOR (adjusted odds ratio) = 5.85, 95 % CI (confidence interval) = 4.83–7.10]. The two indicators of women’s sexual bargaining power (i.e., ability to negotiate condom use and ability to refuse sex) were also positively associated with support of MC. Several sociodemographic factors particularly wealth index were also positively associated with women’s support of MC.

Conclusions

The findings in this study will potentially inform intervention strategies to enhance uptake of male circumcision as a strategy to reduce HIV transmission in Uganda.
Literature
1.
go back to reference Reed JB, Njeuhmeli E, Thomas AG, Bacon MC, Bailey R, Cherutich P, Curran K, Dickson K, Farley T, Hankins C, et al. Voluntary medical male circumcision: an HIV prevention priority for PEPFAR. J Acquir Immune Defic Syndr. 2012;60(3):S88–95.CrossRefPubMedPubMedCentral Reed JB, Njeuhmeli E, Thomas AG, Bacon MC, Bailey R, Cherutich P, Curran K, Dickson K, Farley T, Hankins C, et al. Voluntary medical male circumcision: an HIV prevention priority for PEPFAR. J Acquir Immune Defic Syndr. 2012;60(3):S88–95.CrossRefPubMedPubMedCentral
2.
go back to reference WHO/UNAIDS. Joint strategic action framework to accelerate the scale up of voluntary medical male circumcision fro HIV prevention in Eastern and Southern Africa. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. Geneva: Joint United Nations Programme on HIV/AIDS; 2011. WHO/UNAIDS. Joint strategic action framework to accelerate the scale up of voluntary medical male circumcision fro HIV prevention in Eastern and Southern Africa. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. Geneva: Joint United Nations Programme on HIV/AIDS; 2011.
3.
go back to reference WHO/UNAIDS. New data on male circumcision and HIV PREVENTION: policy and programme implications. WHO/UNAIDS Technical Consultation on Male Circumcision and HIV Prevention: Research Implications for Policy and Programming. Conclusions and Recommendations. Montreux: World Health Organization; 2007. WHO/UNAIDS. New data on male circumcision and HIV PREVENTION: policy and programme implications. WHO/UNAIDS Technical Consultation on Male Circumcision and HIV Prevention: Research Implications for Policy and Programming. Conclusions and Recommendations. Montreux: World Health Organization; 2007.
4.
go back to reference Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2(11), e298.CrossRefPubMedPubMedCentral Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2(11), e298.CrossRefPubMedPubMedCentral
5.
go back to reference Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CFM, Campbell RT, Ndinya-Achola JO. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–56.CrossRefPubMed Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CFM, Campbell RT, Ndinya-Achola JO. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–56.CrossRefPubMed
6.
go back to reference Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton LH, Chaudhary MA, Chen MZ, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.CrossRefPubMed Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton LH, Chaudhary MA, Chen MZ, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.CrossRefPubMed
7.
go back to reference Njeuhmeli E, Forsythe S, Reed J, Opuni M, Bollinger L, Heard N, Castor D, Stover J, Farley T, Menon V, et al. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa. PLoS Med. 2011;8(11), e1001132.CrossRefPubMedPubMedCentral Njeuhmeli E, Forsythe S, Reed J, Opuni M, Bollinger L, Heard N, Castor D, Stover J, Farley T, Menon V, et al. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa. PLoS Med. 2011;8(11), e1001132.CrossRefPubMedPubMedCentral
8.
go back to reference WHO. Progress in scaling up voluntary medical male circumcision for HIV prevention in East and Southern Africa January—December 2012. Africa Republic of Congo: World Health Organization; 2013. WHO. Progress in scaling up voluntary medical male circumcision for HIV prevention in East and Southern Africa January—December 2012. Africa Republic of Congo: World Health Organization; 2013.
9.
go back to reference Lanham M, L’Engle KL, Loolpapit M, Oguma IO. Women’s roles in voluntary medical male circumcision in Nyanza Province, Kenya. PLoS ONE. 2012;7(9), e44825.CrossRefPubMedPubMedCentral Lanham M, L’Engle KL, Loolpapit M, Oguma IO. Women’s roles in voluntary medical male circumcision in Nyanza Province, Kenya. PLoS ONE. 2012;7(9), e44825.CrossRefPubMedPubMedCentral
10.
go back to reference Ngalande R, Levy J, Kapondo CN, Bailey R. Acceptability of male circumcision for prevention of HIV infection in Malawi. AIDS Behav. 2006;10(4):377–85.CrossRefPubMed Ngalande R, Levy J, Kapondo CN, Bailey R. Acceptability of male circumcision for prevention of HIV infection in Malawi. AIDS Behav. 2006;10(4):377–85.CrossRefPubMed
11.
go back to reference Shacham E, Godlonton S, Thornton RL. Perceptions of male circumcision among married couples in rural Malawi. J Int Assoc Provid AIDS Care. 2014;13(5):443–9.CrossRefPubMed Shacham E, Godlonton S, Thornton RL. Perceptions of male circumcision among married couples in rural Malawi. J Int Assoc Provid AIDS Care. 2014;13(5):443–9.CrossRefPubMed
12.
go back to reference Westercamp M, Agot KE, Ndinya-Achola J, Bailey RC. Circumcision preference among women and uncircumcised men prior to scale-up of male circumcision for HIV prevention in Kisumu, Kenya. AIDS Care. 2012;24(2):157–66.PubMed Westercamp M, Agot KE, Ndinya-Achola J, Bailey RC. Circumcision preference among women and uncircumcised men prior to scale-up of male circumcision for HIV prevention in Kisumu, Kenya. AIDS Care. 2012;24(2):157–66.PubMed
13.
go back to reference Westercamp N, Bailey RC. Acceptability of male circumcision for prevention of HIV/AIDS in Sub-Saharan Africa: a review. AIDS Behav. 2007;11(3):341–55.CrossRefPubMed Westercamp N, Bailey RC. Acceptability of male circumcision for prevention of HIV/AIDS in Sub-Saharan Africa: a review. AIDS Behav. 2007;11(3):341–55.CrossRefPubMed
14.
go back to reference Bailey RC, Muga R, Poulussen R, Abicht H. The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya. AIDS Care. 2002;14(1):27–40.CrossRefPubMed Bailey RC, Muga R, Poulussen R, Abicht H. The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya. AIDS Care. 2002;14(1):27–40.CrossRefPubMed
15.
go back to reference Jones D, Cook R, Arheart K, Redding CA, Zulu R, Castro J, Weiss SM. Acceptability, knowledge, beliefs, and partners as determinants of Zambian men’s readiness to undergo medical male circumcision. AIDS Behav. 2014;18(2):278–84.CrossRefPubMedPubMedCentral Jones D, Cook R, Arheart K, Redding CA, Zulu R, Castro J, Weiss SM. Acceptability, knowledge, beliefs, and partners as determinants of Zambian men’s readiness to undergo medical male circumcision. AIDS Behav. 2014;18(2):278–84.CrossRefPubMedPubMedCentral
16.
go back to reference Cook R, Jones D, Redding CA, Zulu R, Chitalu N, Weiss SM. Female partner acceptance as a predictor of men’s readiness to undergo voluntary medical male circumcision in Zambia: the spear and shield project. AIDS Behav. 2015;1:11. Cook R, Jones D, Redding CA, Zulu R, Chitalu N, Weiss SM. Female partner acceptance as a predictor of men’s readiness to undergo voluntary medical male circumcision in Zambia: the spear and shield project. AIDS Behav. 2015;1:11.
17.
go back to reference Friedland BA, Apicella L, Schenk KD, Sheehy M, Hewett PC. How informed are clients who consent? A mixed-method evaluation of comprehension among clients of male circumcision services in Zambia and Swaziland. AIDS Behav. 2013;17(6):2269–82.CrossRefPubMed Friedland BA, Apicella L, Schenk KD, Sheehy M, Hewett PC. How informed are clients who consent? A mixed-method evaluation of comprehension among clients of male circumcision services in Zambia and Swaziland. AIDS Behav. 2013;17(6):2269–82.CrossRefPubMed
18.
go back to reference Mattson CL, Bailey RC, Muga R, Poulussen R, Onyango T. Acceptability of male circumcision and predictors of circumcision preference among men and women in Nyanza Province, Kenya. AIDS Care. 2005;17(2):182–94.CrossRefPubMed Mattson CL, Bailey RC, Muga R, Poulussen R, Onyango T. Acceptability of male circumcision and predictors of circumcision preference among men and women in Nyanza Province, Kenya. AIDS Care. 2005;17(2):182–94.CrossRefPubMed
19.
go back to reference Maughan-Brown B, Venkataramani AS. Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa. PLoS ONE. 2012;7(7), e40753.CrossRefPubMedPubMedCentral Maughan-Brown B, Venkataramani AS. Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa. PLoS ONE. 2012;7(7), e40753.CrossRefPubMedPubMedCentral
20.
go back to reference Kelly A, Kupul M, Aeno H, Shih P, Naketrumb R, Neo J, Fitzgerald L, Kaldor JM, Siba PM, Vallely A. Why women object to male circumcision to prevent HIV in a moderate-prevalence setting. Qual Health Res. 2013;23(2):180–93.CrossRefPubMed Kelly A, Kupul M, Aeno H, Shih P, Naketrumb R, Neo J, Fitzgerald L, Kaldor JM, Siba PM, Vallely A. Why women object to male circumcision to prevent HIV in a moderate-prevalence setting. Qual Health Res. 2013;23(2):180–93.CrossRefPubMed
21.
go back to reference Uganda Ministry of Health, ICF International Inc. Uganda AIDS Indicator Survey 2011. Kampala: Uganda Ministry of Health, ICF International Inc; 2012. Uganda Ministry of Health, ICF International Inc. Uganda AIDS Indicator Survey 2011. Kampala: Uganda Ministry of Health, ICF International Inc; 2012.
22.
go back to reference De Leeuw J, Meijer E. Handbook of multilevel analysis. New York: Springer; 2008.CrossRef De Leeuw J, Meijer E. Handbook of multilevel analysis. New York: Springer; 2008.CrossRef
23.
go back to reference Hedeker D. Multilevel models for ordinal and nominal variables. In: Leeuw J, Meijer E, editors. Handbook of multilevel analysis. New York: Springer; 2008. p. 237–74.CrossRef Hedeker D. Multilevel models for ordinal and nominal variables. In: Leeuw J, Meijer E, editors. Handbook of multilevel analysis. New York: Springer; 2008. p. 237–74.CrossRef
24.
go back to reference Lépine A, Terris-Prestholt F, Vickerman P. Determinants of HIV testing among Nigerian couples: a multilevel modelling approach. Health Policy Plan. 2015;30(5):579–92.CrossRefPubMed Lépine A, Terris-Prestholt F, Vickerman P. Determinants of HIV testing among Nigerian couples: a multilevel modelling approach. Health Policy Plan. 2015;30(5):579–92.CrossRefPubMed
25.
go back to reference Siddiqui O, Hedeker D, Flay BR, Hu FB. Intraclass correlation estimates in a school-based smoking prevention study outcome and mediating variables, by sex and ethnicity. Am J Epidemiol. 1996;144(4):425–33.CrossRefPubMed Siddiqui O, Hedeker D, Flay BR, Hu FB. Intraclass correlation estimates in a school-based smoking prevention study outcome and mediating variables, by sex and ethnicity. Am J Epidemiol. 1996;144(4):425–33.CrossRefPubMed
26.
go back to reference Mavhu W, Buzdugan R, Langhaug LF, Hatzold K, Benedikt C, Sherman J, Laver SM, Mundida O, Woelk G, Cowan FM. Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe. Tropical Med Int Health. 2011;16(5):589–97.CrossRef Mavhu W, Buzdugan R, Langhaug LF, Hatzold K, Benedikt C, Sherman J, Laver SM, Mundida O, Woelk G, Cowan FM. Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe. Tropical Med Int Health. 2011;16(5):589–97.CrossRef
27.
go back to reference Mugwanya KK, Baeten JM, Nakku-Joloba E, Katabira E, Celum C, Tisch D, Whalen C. Knowledge and Attitudes About Male Circumcision for HIV-1 Prevention among Heterosexual HIV-1 Serodiscordant Partnerships in Kampala, Uganda. AIDS Behav. 2010;14(5):1190–7.CrossRefPubMedPubMedCentral Mugwanya KK, Baeten JM, Nakku-Joloba E, Katabira E, Celum C, Tisch D, Whalen C. Knowledge and Attitudes About Male Circumcision for HIV-1 Prevention among Heterosexual HIV-1 Serodiscordant Partnerships in Kampala, Uganda. AIDS Behav. 2010;14(5):1190–7.CrossRefPubMedPubMedCentral
28.
go back to reference Scott BE, Weiss HA, Viljoen J. The acceptability of male circumcision as an HIV intervention among a rural Zulu population, Kwazulu-Natal, South Africa. AIDS Care. 2005;17(3):304–13.CrossRefPubMed Scott BE, Weiss HA, Viljoen J. The acceptability of male circumcision as an HIV intervention among a rural Zulu population, Kwazulu-Natal, South Africa. AIDS Care. 2005;17(3):304–13.CrossRefPubMed
29.
go back to reference Halperin DT, Fritz K, McFarland W, Woelk G. Acceptability of adult male circumcision for sexually transmitted disease and HIV prevention in Zimbabwe. Sex Transm Dis. 2005;32(4):238–9.CrossRefPubMed Halperin DT, Fritz K, McFarland W, Woelk G. Acceptability of adult male circumcision for sexually transmitted disease and HIV prevention in Zimbabwe. Sex Transm Dis. 2005;32(4):238–9.CrossRefPubMed
30.
go back to reference Weiss HA, Halperin D, Bailey RC, Hayes RJ, Schmid G, Hankins CA. Male circumcision for HIV prevention: from evidence to action? AIDS (London, England). 2008;22(5):567–74.CrossRef Weiss HA, Halperin D, Bailey RC, Hayes RJ, Schmid G, Hankins CA. Male circumcision for HIV prevention: from evidence to action? AIDS (London, England). 2008;22(5):567–74.CrossRef
31.
go back to reference Tram KH, Bertrand JT. Correlates of male circumcision in Eastern and Southern African countries: establishing a baseline prior to VMMC Scale-up. PLoS ONE. 2014;9:e100775.CrossRefPubMedPubMedCentral Tram KH, Bertrand JT. Correlates of male circumcision in Eastern and Southern African countries: establishing a baseline prior to VMMC Scale-up. PLoS ONE. 2014;9:e100775.CrossRefPubMedPubMedCentral
32.
go back to reference Uganda Ministry of Health, ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala: Uganda Ministry of Health, ICF International Inc; 2012. Uganda Ministry of Health, ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala: Uganda Ministry of Health, ICF International Inc; 2012.
Metadata
Title
Factors associated with married women’s support of male circumcision for HIV prevention in Uganda: a population based cross–sectional study
Authors
Komi Mati
Korede K. Adegoke
Hamisu M. Salihu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3385-2

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue