Perceived Risk and Severity of the Uptake of Safe Male Circumcision Services among Young Men Aged 15-24 Years in Rhino Camp Refugees Settlement, Arua District- Uganda

Background Safe male circumcision is a proven cost-effective intervention in reducing the risk of sexual transmission of Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome among heterosexual individuals by 60%. This study aimed at exploring the perceived risk and severity to the uptake of safe male circumcision among young men aged 15–24 years in Rhino Camp Refugees Settlement, Arua District, Uganda. Methods This was a cross-sectional study among 378 respondents, which utilized both quantitative and qualitative approaches with a semi-structured and three focus group discussions conducted among young men aged 15–24 years. Univariate analysis was used to determine the uptake of safe male circumcision. Chi-square test and binary regression model were used to determine the odds ratio at 95% confidence levels of safe male circumcision uptake and other exposure variables. Results from the focus group discussions were analysed thematically. Results The prevalence of safe male circumcision uptake was 42.1%. The major factor associated with increased likelihood of safe male circumcision uptake was the perceived benefit of cervical cancer prevention in my partner (AOR = 2.455, 95% CI = 1.278–3.627). Factors associated with reduced likelihood safe male circumcision uptake included: fear of perceived increased risk of meatitis (AOR = 0.726, 95% CI = 0.338- .959), fear that undergoing safe male circumcision is very painful and uncomfortable (AOR = 0.742, 95%, CI = 0.279–1.973). Also, the perception that safe make circumcision is not affordable at most private health facilities (AOR = 0.167, 95%, CI = 0.058–0.478). Conclusions Safe make circumcision uptake in Rhino Refugees Settlement is lower than Uganda’s national target of 80%. This is attributed to the perceived risks such as perceived risk of infection, pain, irritability, and costs involved. Awareness creation on myths and misconceptions is key to increasing up take of safe make circumcision.

The Factors That Have Led To Increased HIV/AIDS Prevalence Among Adolescents Aged 13-21 Years In Hoima Regional Referral Hospital, Hoima District.

Background: The study broad objective was to determine the factors influencing the increasing prevalence of HIV/ AIDS among adolescents to suggest relevant and appropriate interventions that may be applied in the future in order to decrease the prevalence and combat HIV/ AIDS. Methodology: Across sectional study was carried out at Hoima Regional Referral Hospital to determine the factors which have influenced HIV/AIDS prevalence among adolescents from 12th March 2013 to 18th March 2013. Data were collected from adolescents who attended OPD services and it involved interviewing the adolescents using a questionnaire by the researcher on the demographics, HIV-related knowledge, awareness, and attitudes on preventive measures and social factors that influence the increase in HIV prevalence. The data was analyzed manually using a scientific calculator and was compiled in form of tables, pie charts, and bar graphs Results: Unplanned sex (35%), Beautiful partners (22%), the influence of partners (4%), presence of AVRs(10%), and Fear to buy condoms(29%), were the factor that has led to the increased HIV/AIDS amongst adolescents. Conclusion: The involvement of other sectors of a community like local councils, learning institutions, churches, civil society organizations, and NGOs will do a long way in promoting effective knowledge to the adolescents about HIV preventive measures. Recommendations: The government through the ministry of health should continue to sensitize adolescents through health education about ABC strategies and safe male circumcision importance in an effort to combat HIV new infections.

Safe Male Circumcision for HIV Prevention among Adolescents with Deafness in Uganda: Awareness, Prevalence and Implications for Policy and Programming

Background: Safe Male Circumcision (SMC)[1] has been widely recommended by WHO as part of a comprehensive HIV prevention strategy. However, literature pertaining to SMC amongst adolescents with a disability, and the deaf community in particular, is almost non-existent. This study sought to establish SMC prevalence, knowledge, attitude and post circumcision behaviour among adolescents with deafness in Uganda. Methods: The study was cross-sectional, used a mixed-methods approach and recruited 447 participants. 363 questionnaires were administered to adolescents of age 15 - 24 years (192 males and 171 females) from three study sites. We assessed socio-demographic variables, circumcision status, post circumcision behaviour, attitude and knowledge levels towards SMC. Qualitative data was also collected from 84 participants (m=46, f=38) using focus group discussions and key informant interviews. Quantitative data were analysed using Stata software while qualitative was thematically analysed. Results: A total of 60.9% male adolescents with deafness self-reported to be circumcised. Both male and female participants reported SMC information to be highly inaccessible (84%). Only 27.8% study participants knew about the partial protective effect of SMC against HIV, 51.8% were uncertain, while 26% thought that SMC provided full protection. Both male and female respondents had a positive attitude towards SMC (68.3%) and females were more knowledgeable (50.3%) about the partial preventive effect of SMC against HIV transmission and timeframe for the resumption of sexual activity compared to males (30.2%). Linkages were noted between SMC, social networks and key sociodemographic characteristics like ethnicity, religion and education level. Conclusion: Despite a 60.9% prevalence and general positive attitude towards SMC, study findings showed limited service access and substantial knowledge gaps in SMC efficacy, also related to high-risk behaviour after circumcision. This can largely be explained by limited targeting by HIV prevention programmes among this (deaf) category of adolescents, related barriers associated with vulnerability arising from their disability (deafness) and developmental stage (adolescence). Key actors in HIV prevention efforts should demonstrate cognizance of heightened risk among vulnerable adolescent categories through more inclusive interventions to address prevailing knowledge and service gaps. [1] This study was conducted between 2015-2016 when the commonly used term was Safe Male Circumcision (SMC) and not Voluntary Medical Male Circumcision (VMMC) as its popularly being packaged now. This manuscript has stuck to the originally used SMC acronym.

Utilization of safe male circumcision among adult men in a fishing community in rural Uganda

Background: In Uganda, most-at-riskpopulations(MARPs) such as fishing communities remain vulnerable to preventable HIV acquisition. Safe Male Circumcision (SMC) has been incorporated into Uganda’s HIV prevention strategies. This study aimed at determining SMC utilization and associated factors among adult men in a rural fishing community in Uganda.Methods: A cross-sectional study was conducted in a rural fishing village in central Uganda. Stratified random sampling of 369 fishermen aged 18-54 yearswas used according to their occupational category; fish monger, boat crew and general merchandise.The dependent variable wasutilization of SMC.A forward fitting multivariable logistic regression model was fitted with variables significant at p≤0.05controlling for confounding and effect modification.Results: Respondents’mean(SD) age was 30.0(9.3) years. Only8.4%hadSMC and among non-circumcised men, 84.9% had adequate knowledge of SMC benefits while 79.3% did not know were SMC services were offered.Peer support(AOR0.17;95%CI0.05-0.60) and perceived procedural safety (AOR6.8;95%CI2.16-21.17) were independently associated with SMC utilization.Conclusion: In this rural fishing community, SMC utilization was low. These findings underscore the need to inform HIV preventionstrategies inthecontextof peer support and perceptionsheld by rural dwelling men.Keywords: Safe male circumcision, utilization, fishing community, Most-at-risk populations, Uganda.

Prevalence and factors associated with safe male circumcision among Makerere University undergraduate students, Kampala - Uganda

Background Safe male circumcision (SMC) is currently recognized as a preventive strategy in reducing the risk of HIV; however, the prevalence of circumcised men in Uganda is still quite low at 26%. This study aimed to determine the prevalence and factors associated with SMC and among Makerere University undergraduate students, in Kampala Uganda. Methods We conducted a cross-sectional study among 602 participants selected using multistage probability sampling strategy. Pretested semi-structured questionnaires and focus group discussions were used to collect data. Quantitative data were analyzed with Stata 12.0, the prevalence ratio and p-values were calculated. Possible interactions and confounding variables were assessed with the Poisson regression model while qualitative data was analyzed with content analysis. Results The overall prevalence of safe male circumcision among male undergraduates was 58.3% (95% CI: 54.37 – 62.24). Factors associated with SMC prevalence included: safety of SMC procedure (Prevalence Ratio (PR) = 1.13, 95% Confidence Interval (CI): 1.03 – 1.25) and friendly health workers (PR = 0.78, 95% CI: 0.74 – 0.83). The perceived benefits of SMC included hygiene (86.5%, n = 521), reduced risk of HIV transmission (4.5%, n = 26) and reduced risk of penile cancer (45.7%, n = 275) while, the perceived barrier was pain (10.1%, n = 61). The students perceived that SMC recipient’s first sexual partner post-procedure should not be his girlfriend. Most participants in all the focus group discussions perceived SMC increases sexual pleasure. Conclusion The overall self-reported SMC success rate among participants was high, along with the safety of SMC services and friendly health workers as important factors among male students. There is a need for continuous sensitization campaigns and communication strategies to address beliefs about SMC, some related misconceptions, and barriers so as to increase its prevalence.