TY - JOUR
T1 - Contextual barriers and motivators to adult male medical circumcision in Rakai, Uganda
AU - Ssekubugu, Robert
AU - Leontsini, Elli
AU - Wawer, Maria J.
AU - Serwadda, David
AU - Kigozi, Godfrey
AU - Kennedy, Caitlin E.
AU - Nalugoda, Fred
AU - Sekamwa, Richard
AU - Wagman, Jennifer
AU - Gray, Ronald H.
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Fogarty International Center/National Institutes of Health training grants numbers 5D43TW001508 and D43TW000010 at the Johns Hopkins Bloomberg School of Public Health.
PY - 2013/6
Y1 - 2013/6
N2 - Medical male circumcision (MMC) is a central component of HIV prevention. In this study we examined barriers to and facilitators of MMC in Rakai, Uganda. Interviews and focus groups with MMC acceptors, decliners, and community members were collected and analyzed iteratively. Themes were developed based on immersion, repeated reading, sorting, and coding of data using grounded theory. Pain, medical complications, infertility, lack of empirical efficacy, waiting time before resumption of sex, and religion were identified as obstacles to MMC acceptance. Prevention and healing of sexually transmitted infections (STIs), access to HIV and other ancillary care, penile hygiene, and peer influence were key motivators. Voluntary counseling and testing for HIV, partner influence, and sexual potency were both barriers and motivators. Individual and societal factors, such as pain and religion, might slow MMC scale up. Health benefits, such as HIV/STI prevention and penile hygiene, are essential in motivating men to accept MMC.
AB - Medical male circumcision (MMC) is a central component of HIV prevention. In this study we examined barriers to and facilitators of MMC in Rakai, Uganda. Interviews and focus groups with MMC acceptors, decliners, and community members were collected and analyzed iteratively. Themes were developed based on immersion, repeated reading, sorting, and coding of data using grounded theory. Pain, medical complications, infertility, lack of empirical efficacy, waiting time before resumption of sex, and religion were identified as obstacles to MMC acceptance. Prevention and healing of sexually transmitted infections (STIs), access to HIV and other ancillary care, penile hygiene, and peer influence were key motivators. Voluntary counseling and testing for HIV, partner influence, and sexual potency were both barriers and motivators. Individual and societal factors, such as pain and religion, might slow MMC scale up. Health benefits, such as HIV/STI prevention and penile hygiene, are essential in motivating men to accept MMC.
KW - Africa, sub-Saharan
KW - HIV/AIDS prevention
KW - focus groups
KW - interviews, semistructured
KW - research, qualitative
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U2 - 10.1177/1049732313482189
DO - 10.1177/1049732313482189
M3 - Article
C2 - 23515302
AN - SCOPUS:84876812986
SN - 1049-7323
VL - 23
SP - 795
EP - 804
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 6
ER -