Uptake of Early Infant Medical Male Circumcision as an HIV Prevention Intervention in Lusaka District

Abstract

Globally, male circumcision has gained popularity as a tool for preventing HIV transmission. According to randomized controlled studies, adult medical male circumcision lowers the risk of HIV transmission in heterosexual males by about 60%. In line with the evidence from various studies on the effectiveness of male circumcision, the World Health Organization (WHO) and UNICEF (2016), endorsed Early Infant Male Circumcision (EIMC) for the prevention of HIV and Zambia is among 14 African nations speeding up the adoption of this intervention. The study utilized a concurrent mixed method design where both quantitative and qualitative methods were used. The study’s quantitative sample size was 400 mothers while under qualitative, 3 Focus Group Discussions (FGDs) were conducted with mothers. Stata version 16 was used to analyze the study's quantitative data, while thematic analysis was employed to examine the qualitative data. The study identified three critical variables that influence Lusaka women's uptake of Early Infant Male Circumcision (EIMC): the partner's circumcision status, women's attitude towards EIMC, and knowledge on EIMC. Furthermore, the study showed that EIMC was more common among women from cultures where male circumcision was practiced. Key deterrents to EIMC uptake were highlighted by the qualitative part of the study as medical distrust, cultural practices around traditional male circumcision, and a lack of awareness that results in misconceptions and myths. The study found that women knew very little about EIMC as an HIV preventive intervention; therefore, intentional policies should be implemented to promote EIMC awareness initiatives and break myths and misconceptions among mothers. It is also essential to acknowledge cultural variations in decision-making. Lastly, promoting male engagement is crucial, with a focus on the support that fathers and other male family members provide for EIMC. Keywords: Early infant, male circumcision, uptake, cultural beliefs