Enhancers and barriers to uptake of male circumcision services in Northern Uganda: a qualitative study.

Enhancers and barriers to uptake of male circumcision services in Northern Uganda: a qualitative study.
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DOI:
10.1080/09540121.2019.1698703
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发表时间:
2020-08
期刊:
影响因子:
1.7
通讯作者:
Kennedy CE
Kennedy CE
中科院分区:
医学4区
文献类型:
--
作者:
Nanteza BM;Makumbi FE;Gray RH;Serwadda D;Yeh PT;Kennedy CE

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乌干达于2010年采用了自愿医疗男性包皮环切术(VMMC),但尽管实施了多项创造需求战略,但北方地区的采用率仍然不成比例地低。本研究探讨了社会文化和结构的增强剂和障碍,在古卢,在乌干达北方的一个区,摄取VMMC服务的摄取是最低的。2016年9月,我们进行了19次焦点小组讨论、9次深度访谈和11次关键信息提供者访谈,共有149名参与者。数据收集和分析的主题使用归纳和演绎的方法,然后在四个层次的社会生态模型的框架。增强剂包括对VMMC服务的充分了解,年轻和单身,合作伙伴的参与,同伴的影响,包皮环切术后的性欲增加,以及免费和高质量的VMMC服务的可用性。障碍包括伤口愈合期间的禁欲,包皮环切术后的阴茎外观,宗教,文化和误解。优化增强器和解决障碍可以增加VMMC服务在乌干达北方的吸收。
Uganda adopted voluntary medical male circumcision (VMMC) in 2010, but uptake remains disproportionately low in the Northern region despite implementing several demand creation strategies. This study explored the socio-cultural and structural enhancers and barriers to uptake of VMMC services in Gulu, a district in Northern Uganda where uptake is lowest. In September 2016, we conducted 19 focus group discussions, 9 in-depth interviews, and 11 key informant interviews with 149 total participants. Data were collected and analyzed thematically using both inductive and deductive approaches, then framed in four levels of the social ecological model. Enhancers included adequate knowledge about VMMC services, being young and single, partner involvement, peer influence, perceived increased libido after circumcision, and availability of free and high-quality VMMC services. Barriers included sexual abstinence during wound healing, penile appearance after circumcision, religion, culture, and misconceptions. Optimizing enhancers and addressing barriers could increase VMMC service uptake in northern Uganda.
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