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AIDS and Behavior
Published in: AIDS and Behavior 6/2013

01-07-2013 | Original Paper

How Informed are Clients Who Consent? A Mixed-Method Evaluation of Comprehension Among Clients of Male Circumcision Services in Zambia and Swaziland

Authors: Barbara A. Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

Published in: AIDS and Behavior | Issue 6/2013

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Abstract

Comprehension is fundamental for informed consent—an individual’s right to choose a medical procedure, such as male circumcision (MC). Because optimal benefits depend on post-surgical behaviors, comprehension is particularly critical for MC programs. We evaluated clients’ comprehension of MC’s risks and benefits, wound care instructions, and risk reduction post-MC using a true/false test (n = 1181) and 92 semi-structured interviews (SSIs) in Zambia and Swaziland. Most participants (89 % Zambia, 93 % Swaziland) passed the true/false test, although adolescents scored lower (significantly so in Swaziland) than adults and one-third (including nearly half of adolescents in Zambia) said MC has no risks. SSIs indicated confusion between “risk” of adverse surgical outcomes and reduced “risk” of HIV; most respondents acknowledged the 6 week abstinence period post-MC, yet few said resuming sex early increases HIV risk. Providers should distinguish between surgical “risks” and reduced HIV “risk,” and emphasize that HIV risk increases with sex before complete healing.
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Metadata
Title
How Informed are Clients Who Consent? A Mixed-Method Evaluation of Comprehension Among Clients of Male Circumcision Services in Zambia and Swaziland
Authors
Barbara A. Friedland
Louis Apicella
Katie D. Schenk
Meredith Sheehy
Paul C. Hewett
Publication date
01-07-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-013-0424-1

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