Barriers, benefits, and behaviour: Voluntary medical male circumcision ideation in a population-based sample of Zambian men.
Barriers, benefits, and behaviour: Voluntary medical male circumcision ideation in a population-based sample of Zambian men.
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DOI：
10.2989/16085906.2021.2006727
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Kumoji E'
中科院分区：
文献类型：
--
作者：
Rosen JG;Carrasco MA;Traub AM;Kumoji E'
实现雄心勃勃的自愿医疗男性包皮环切术（VMMC）覆盖率的目标，需要更深入地了解多方面的过程，塑造男子的意愿，获得VMMC。健康传播的思维模式的指导下，这项以人口为基础的研究确定赞比亚男子的未来VMMC意图的相关性。采用多阶段整群抽样方法，在14个区确定有成年男子的家庭。多变量泊松回归与强大的标准误差建模的未来VMMC意图与概念因素（如感知的好处和障碍）和性行为的关联。40%（40%）的未行包皮环切术的男性（N = 1 204）表达了未来VMMC的意图。在多变量分析中，VMMC意图与中学或更高教育程度相关（校正的患病率比[APR] 1.30，95%置信区间[95% CI]：1.02-1.66），认为VMMC可提高性满意度（APR 1.45，95% CI：1.11-1.89），报告称服务距离是VMMC采用的障碍（APR = 0.54，95% CI：1.27-1.87），末次无保护性行为（APR 1.54，95% CI：1.11-2.14），过去12个月内有≥ 2个性伴侣（APR 1.45，95% CI：1.05-1.99）。年龄≥ 45岁（vs 18-24岁：APR 0.23，95% CI：0.13-0.40），认为包皮环切术：（1）不重要（APR 0.71，95%CI：0.51-0.98）;（2）与当地习俗不一致（APR 0.41，95%CI：0.18-0.94）;或（3）性满意度降低（APR 0.10，95%CI：0.02-0.62）与未来VMMC意图呈负相关。创造需求的努力必须面对显著的认知和社会障碍，包括对与当地习俗不相容的担忧。与此同时，宣传工作应强调VMMC的相关好处，而不是加强有害的性别规范，这些好处超出了艾滋病毒预防的范围，与男性产生共鸣（例如阴茎卫生）。
Reaching ambitious voluntary medical male circumcision (VMMC) coverage targets requires a deeper understanding of the multifaceted processes shaping men’s willingness to access VMMC. Guided by the Ideation Model for Health Communication, this population-based study identifies correlates of Zambian men’s future VMMC intentions. Multistage cluster sampling was used to identify households with adult men in 14 districts. Multivariable Poisson regression with robust standard errors modelled associations of future VMMC intent with ideational factors (e.g. perceived benefits and barriers) and sexual behaviours respectively. Forty per cent (40%) of uncircumcised men (N = 1 204) expressed future VMMC intentions. In multivariable analysis, VMMC intent was associated with secondary education or higher (Adjusted Prevalence Ratio [APR] 1.30, 95% Confidence Interval [95% CI]: 1.02–1.66), perceiving VMMC to increase sexual satisfaction (APR 1.45, 95% CI: 1.11–1.89), reporting distance to services as a barrier to VMMC uptake (APR = 0.54, 95% CI: 1.27–1.87), unprotected last sex (APR 1.54, 95% CI: 1.11–2.14), and ≥ 2 sexual partners in the past 12 months (APR 1.45, 95% CI: 1.05–1.99). Being aged ≥ 45 years (vs 18–24 years: APR 0.23, 95% CI: 0.13–0.40) and perceiving that circumcision: (1) is unimportant (APR 0.71, 95% CI: 0.51–0.98); (2) is incompatible with local customs (APR 0.41, 95% CI: 0.18–0.94); or (3) reduces sexual satisfaction (APR 0.10, 95% CI: 0.02–0.62) were inversely associated with future VMMC intent. Demand-creation efforts must confront salient cognitive and social barriers to VMMC uptake, including concerns around incompatibility with local customs. Simultaneously, promotional efforts should emphasise relevant VMMC benefits beyond HIV prevention that resonate with men (e.g. penile hygiene) without reinforcing harmful gender norms.
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DOI：
10.1093/cid/cix951
发表时间：
2018-04-03
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Patel EU;Kaufman MR;Dam KH;Van Lith LM;Hatzold K;Marcell AV;Mavhu W;Kahabuka C;Mahlasela L;Njeuhmeli E;Seifert Ahanda K;Ncube G;Lija G;Bonnecwe C;Tobian AAR
通讯作者：
Tobian AAR
影响因子：
4.5
作者：
Chatsika, Zimveka Jones;Kumitawa, Andrew;Jumbe, Vincent C.
通讯作者：
Jumbe, Vincent C.
影响因子：
3.3
作者：
Adams, Alfred;Moyer, Eileen
通讯作者：
Moyer, Eileen
影响因子：
6
作者：
Kibira, Simon Peter Sebina;Atuyambe, Lynn Muhimbuura;Daniel, Marguerite
通讯作者：
Daniel, Marguerite
影响因子：
3.7
作者：
Marshall, Esaie;Rain-Taljaard, Reathe;Auvert, Bertran
通讯作者：
Auvert, Bertran