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PLoS One. 2017 Oct 5;12(10):e0185872. doi: 10.1371/journal.pone.0185872. eCollection 2017.
Predictors of voluntary medical male circumcision prevalence among men aged 25-39 years in Nyanza region, Kenya: Results from the baseline survey of the TASCO study.
Odoyo-June E1, Agot K2, Grund JM3, Onchiri F1, Musingila P1, Mboya E2, Emusu D1, Onyango J2, Ohaga S2, Soo L1, Otieno-Nyunya B1.
1
Division of Global HIV & TB (DGHT), U.S. Centers for Disease Control and Prevention (CDC), Nairobi, Kenya.
2
Impact Research and Development Organization, Kisumu, Kenya.
3
Division of Global HIV & TB (DGHT), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States of America.
Abstract below; full text is at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0185872
INTRODUCTION:
Uptake of voluntary medical male circumcision (VMMC) as an intervention for prevention of HIV acquisition has been low among men aged ≥25 years in Nyanza region, western Kenya. We conducted a baseline survey of the prevalence and predictors of VMMC among men ages 25-39 years as part of the preparations for a cluster randomized controlled trial (cRCT) called the Target, Speed relojes de imitacion suizos and Coverage (TASCO) Study. The TASCO Study aimed to assess the impact of two demand creation interventions-interpersonal communication (IPC) and dedicated service outlets (DSO), delivered separately and together (IPC + DSO)-on VMMC uptake.
METHODS:
As part of the preparatory work for implementation of the cRCT to evaluate tailored interventions to improve uptake of VMMC, we conducted a survey of men aged 25-39 years from a traditionally non-circumcising Kenyan ethnic community within non-contiguous locations selected as study sites. We determined their circumcision status, estimated the baseline circumcision prevalence and assessed predictors of being circumcised using univariate and multivariate logistic regression.
RESULTS:
A total of 5,639 men were enrolled of which 2,851 (50.6%) reported being circumcised. The odds of being circumcised were greater for men with secondary education (adjusted Odds Ratio (aOR) = 1.65; 95% CI: 1.45-1.86, p<0.001), post-secondary education (aOR = 1.72; 95% CI: 1.44-2.06, p <0.001), and those employed (aOR = 1.32; 95% CI: 1.18-1.47, p <0.001). However, the odds were lower for men with a history of being married (currently married, divorced, separated, or widowed).
CONCLUSION:
Among adult men in the rural Nyanza region of Kenya, men with post-primary education and employed were more likely to be circumcised. VMMC programs should focus on specific omega replica sub-groups of men, including those aged 25-39 years who are married, divorced/separated/ widowed, and of low socio-economic status (low education and unemployed).