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Increasing Availability and Acceptability of Circumcision in Zambia

提高赞比亚包皮环切术的可用性和可接受性

基本信息

批准号：
8658730
负责人：
STEPHEN M. WEISS
金额：
$ 46.09万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-15 至 2015-12-09
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8658730
关键词：
AIDS prevention AIDS/HIV problem Affect African Attention Attitude Behavior Therapy Behavioral Communities Community Health Centers Control Groups Counseling Country Demographic and Health Surveys Disinhibition Eastern Africa Ensure Equilibrium Female Financial compensation Fright General Population Goals Gray unit of radiation dose HIV HIV Infections Health Health Personnel Heterosexuals Hospitals Incidence Intervention Kenya Maintenance Male Circumcision Modeling Operative Surgical Procedures Outcome Pain Paint Participant Patients Perception Performance Play Population Portraits Preparation Prevalence Prevention strategy Qualifying Recommendation Research Risk Risk Reduction Role Services Sex Behavior Sex Functioning Sexual Partners Southern Africa Staging Surveys Testing Time Training Zambia adverse outcome biobehavior cohort evidence base follow-up improved innovation interest male men policy implication population based preference prevent programs prospective response satisfaction scale up standard of care treatment as usual uptake willingness

项目摘要

DESCRIPTION (provided by applicant): Male circumcision (MC) has been proven to be a potent HIV prevention strategy in Southern and Eastern Africa, reducing risk of HIV acquisition in men by 50-60%. In response to WHO recommendations to establish national programs to promote MC, the Zambian Ministry of Health has created the National Male Circumcision Strategy and Implementation Plan (2010-2020), with the goal of performing 2.5 million circumcisions by 2020, or 250,000 circumcisions per year. However, recent evidence from the population-based Zambia Sexual Behaviour Survey (2010) indicates that of the 88% of the Zambian male population who are uncircumcised, over 80% express no interest in undergoing male circumcision as an HIV prevention strategy.[NB: only 25,000 circumcisions were performed over the past 12 months]. Reaching the national goal will require significantly increasing the available pool of qualified health care providers (from 400 to 1500) to perform circumcisions (supply), as well as developing effective community-level behavioral change interventions promoting circumcision among the population as an acceptable means of reducing risk of HIV infection (demand). This application proposes to test a "biobehavioral partnership" to simultaneously improve both circumcision acceptability and availability at the community health center level. Study hypotheses will test whether circumcision programs which combine an evidence-based sexual risk reduction/MC promotion intervention with competent biomedical MC services at the community level will 1) be more likely to achieve the rates of circumcision necessary to reach the goals of the Zambian National Circumcision Plan than those programs offering biomedical MC services alone while 2) preventing risk compensation/behavioral disinhibition among those undergoing MC. Successful outcomes from this innovative study will have major policy implications for HIV prevention across Southern and Eastern Africa over the next ten years.

描述（由申请人提供）：男性包皮环切术（MC）已被证明是南部和东部非洲有效的艾滋病毒预防策略，可将男性感染艾滋病毒的风险降低50- 60%。为响应世卫组织关于制定国家方案以促进生殖器切割的建议，赞比亚卫生部制定了《国家男性包皮环切战略和实施计划》（2010-2020年），目标是到2020年进行250万例包皮环切手术，即每年25万例包皮环切手术。然而，赞比亚基于人口的性行为调查（2010年）的最新证据表明，在88%未接受包皮环切的赞比亚男性人口中，80%以上的人表示没有兴趣接受包皮环切作为预防艾滋病毒的战略。[NB：在过去12个月中，仅进行了25 000例包皮环切术]。要实现国家目标，就需要大幅度增加合格的卫生保健提供者的人数（从400人增加到1 500人），以实施包皮环切术（供应），并制定有效的社区一级行为改变干预措施，在人口中推广包皮环切术，将其作为一种可接受的降低艾滋病毒感染风险的手段（需求）。本申请提出测试“生物行为伙伴关系”，以同时提高社区卫生中心水平的包皮环切术的可接受性和可用性。研究假设将测试结合联合收割机循证性风险降低/MC促进干预与社区一级主管生物医学MC服务的割包皮方案是否1）比仅提供生物医学MC服务的方案更有可能达到赞比亚国家割包皮计划目标所需的割包皮率，同时2）防止风险补偿/MC促进干预。行为抑制解除。这项创新研究的成功结果将对未来十年南部和东部非洲的艾滋病毒预防产生重大政策影响。