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Prevalence and Predictors of Uncircumcised, Kenyan Men’s Desire for Circumcision for Their Infant Sons

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Abstract

Men are key decision makers for their son’s circumcision, so understanding their beliefs is important for the uptake of early infant male circumcision in countries in sub-Saharan Africa that have high HIV prevalence. We analyzed men’s preferences for circumcising their sons using data from a population-representative survey of 1501 uncircumcised men aged 25–49 years in western Kenya. Most men (59%) reported they would “definitely” want their son circumcised if a son was born to them within the next year. However, only 25% intended to become circumcised themselves. In multivariable Poisson regression models to estimate prevalence ratios, key predictors of the desire to circumcise their sons included knowledge that circumcision reduces HIV acquisition, having a supportive partner, discussing circumcision with the partner, altruism, and intention to be circumcised himself. Focusing on partner dynamics may have the greatest capacity to increase demand since 55% had not talked to their partner about circumcision.

Resumen

Los hombres son decisores clave para la circuncisión de su hijo, por lo que la comprensión de sus creencias es importante para la adopción de la circuncisión masculina infantil en los países de África subsahariana que tienen alta prevalencia del VIH. Analizamos las preferencias de los hombres para circuncidar a sus hijos usando datos de una encuesta representativa de la población de 1.501 hombres no circuncidados de 25 a 49 años en el oeste de Kenia. La mayoría de los hombres (59%) informaron que “definitivamente” querían que su hijo circuncidara si un hijo naciera para ellos dentro del próximo año. Sin embargo, sólo el 25% pretendía circuncidarse. En los modelos multivariables de regresión de Poisson para estimar las tasas de prevalencia, los principales predictores del deseo de circuncidar a sus hijos incluyeron el conocimiento de que la circuncisión reduce la adquisición del VIH, tener un compañero de apoyo, discutir la circuncisión con el compañero, el altruismo y la intención de circuncidarse. Centrarse en la dinámica de los socios puede tener la mayor capacidad para aumentar la demanda ya que el 55% no había hablado con su pareja sobre la circuncisión.

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Acknowledgements

We would like to thank Tim Van Acker for designing the database and Megan Bronson for coordinating the study. This study would not have been possible without the support and effort of the study staff, participants, community advisory board, and the Ministry of Health leadership in Nyando district. The study was funded by the Bill and Melinda Gates Foundation (Grant No. OPP1069673). HT acknowledges support from the National Institute for Child Health and Human Development (Grant No. K01HD061605). FPH acknowledges support from the National Institute of Health (Grant Nos. 5-T32-AI070114-09 & 5-T32-AI07001-38).

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Authors and Affiliations

  1. Department of Internal Medicine, Dell Medical School, University of Texas at Austin, 1912 Speedway, SZB 546.05, Austin, TX, 78712, USA

    F. Parker Hudson

  2. Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    F. Parker Hudson & William C. Miller

  3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    F. Parker Hudson & William C. Miller

  4. Impact Research and Development Organization, Kisumu, Kenya

    Samwel Rao & Kawango Agot

  5. Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Harsha Thirumurthy

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  1. F. Parker Hudson
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  2. William C. Miller
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  3. Samwel Rao
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  4. Kawango Agot
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  5. Harsha Thirumurthy
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Correspondence to F. Parker Hudson.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hudson, F., Miller, W.C., Rao, S. et al. Prevalence and Predictors of Uncircumcised, Kenyan Men’s Desire for Circumcision for Their Infant Sons. AIDS Behav 22, 471–478 (2018). https://doi.org/10.1007/s10461-017-1681-1

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  • DOI: https://doi.org/10.1007/s10461-017-1681-1

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