Male circumcision uptake during the Botswana Combination Prevention Project

Area of Science:

• Public Health
• Infectious Disease Prevention
• HIV/AIDS Research

Background:

• Voluntary medical male circumcision (VMMC) is a key HIV prevention strategy.
• Uptake of VMMC services has been suboptimal in several regions, including Botswana.
• Understanding factors influencing VMMC uptake is crucial for effective demand creation.

Purpose of the Study:

• To examine sociodemographic characteristics associated with VMMC uptake in Botswana.
• To evaluate the effectiveness of referral procedures from HIV testing venues to VMMC services.
• To inform targeted demand creation strategies for VMMC.

Main Methods:

• Analysis of data from the Botswana Combination Prevention Project (BCPP), a community-randomized trial.
• Assessment of baseline male circumcision status among men eligible for HIV testing.
• Logistic regression analysis to identify factors associated with VMMC uptake.

Main Results:

• Among uncircumcised men, only 10% underwent VMMC.
• Younger (16-24 years), unemployed men, and those tested at mobile venues showed higher VMMC uptake.
• Fear of pain was the primary reason for declining circumcision (27%).

Conclusions:

• VMMC uptake is influenced by age, employment status, and testing location.
• HIV testing programs can serve as a platform to promote VMMC.
• Tailored strategies are needed to overcome barriers for older and employed men.