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Transcript of MAKING A DIFFERENCE IN PEOPLE'S LIVES 16 th ICASA CONFERENCE 4-8 th December Millennium Hall, Addis...
MAKING A DIFFERENCE IN PEOPLE'S LIVES
16th ICASA CONFERENCE
4-8th December Millennium Hall, Addis Ababa-Ethiopia
Attitudes and Acceptability of Male Circumcision: One Year after Launch of the
National Male Circumcision Policy in Uganda
Presenter: Robert NangaiCo-authors: Esther Kaggwa, Simon Ndizeye, Cheryl Lettenmaier, Ruth
Museruka
Health Communication Partnership
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Overview
• 1.2 million Ugandans living with HIV• Over 130,000 new infections every year• MC reduces the risk of HIV infection by 60% • 25% of Ugandans currently circumcised • Circumcising 4.2 million men in 5 years can avert
400,000 new infections• Limited locations where MMC is available
MAKING A DIFFERENCE IN PEOPLE'S LIVES
MMC Communication 2008 - 2010
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Study Methodology
• Household survey in 31 districts• November – December, 2010• Interviewed 2,896 individuals aged 15-54 years• Multi stage stratified sampling for young people
aged 15-24 and adults 25-54• Objectives:
To evaluate the reach and effects of HCP supported communication activities
To provide baseline measures for new communication activities
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Respondent CharacteristicsCharacteristics Number Percentage
No. of respondents 2,896
MaleFemale
1,3791,517
4852
15-2425-49
1,4831,413
5149
RuralUrban
2,174722
7525
Non-circumcising culture
2,200 77
• 61% were aware of Uganda MC Policy• 21% of males had been circumcised (84% circumcised as babies)• 42% reported that their community approves of MC
MAKING A DIFFERENCE IN PEOPLE'S LIVES
• 45% exposed• Males from
urban areas with secondary of higher education more likely to be exposed
Exposure to MMC Messages
52
38 41
57
38
5445
010203040506070
Percent
N = 2896All P < 0.05
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Knowledge of a Place Offering Medical Male Circumcision Services
3238
30
52
26
51 47
25
36
0102030405060
Percent
N = 2,795All P < 0.05
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Percent of Men & Women who Said Male Circumcision is Harmful
20
10
6
3
0 5 10 15 20 25 30
May lead one tocontract HIV
Reduces penis size
Reduces sexual urge
Affects the ability tobare children
Percent
N = 1275
• 29% thought MC is harmful
• Rural, aged 15-17 years, lower SES, & primary or lower education more likely to say MC is harmful
n = 402
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Percent of Men & Women who Said Male Circumcision is Beneficial
3
46
61
0
10
20
30
40
50
60
70
Reduces chances ofcontracting HIV
Reduces chances ofcontracting other
STIs
Reduces worryduring sex
Pe
rce
nt
N = 1275
73% said MC is beneficial
N = 2,082
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Variable Odds ratioEducation levelPrimary and below (ref) 1Secondary and above 1.6
Exposure to MC messages Not exposed to MC messages (ref) 1Exposed to MC messages 3.8Age25-49 years (ref) 115-24 years 2.6Others Marital status** 1.23Residence** 0.86Sexual activity** 1.17
**Not associated with intention to circumcise
Factors Associated with Intention to Circumcise (Multivariate)
N = 1,041
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Conclusions & Recommendations
• Knowledge of a place offering MMC low
• High level of acceptance for MMC
• Exposure to MMC messages strongly associated with intention to circumcise
• Married, older men significantly less likely to intend to circumcise
• MMC communication should focus on older married men & identify services
MAKING A DIFFERENCE IN PEOPLE'S LIVES
Acknowledgements
• Ministry of Health
• MC Working Group
• HCP
• MUSPH
• USAID