A cross-sectional study of the factors associated with male circumcision status among college youth in Ndola, Zambia, 2016

摘要

Background: New cases of HIV are increasing among young adults in Zambia; yet voluntarymedical male circumcision (VMMC) coverage as an HIV prevention measure remains low.Despite having the highest HIV burden in the province, Ndola district had a VMMC coverageof 23% in 2015 compared to the national target of 80% among high-risk groups.Objectives: To determine predictive factors associated with circumcision status among malestudents in Ndola district.Methods: We conducted a cross-sectional study in May 2016 among students aged 18–35 yearsenrolled in five conveniently sampled colleges. We administered a structured questionnaire toassess the knowledge, attitudes and perceptions about VMMC. We used multivariable logisticregression to determine factors associated with male circumcision (MC) status.Results: Of 136 students interviewed, 63% were circumcised, and of those, 96% were medicallycircumcised. Half of all students were aged 21–24 years. Those who perceived the circumcisionprocedure to be ‘safe’ (adjusted odds ratio [aOR] = 5.13; 95% CI: 2.09–14.82), and knew that itreduced female to male HIV transmission risk (aOR = 3.65; 95% CI: 3.12–11.67), were morelikely to be circumcised. The perception that MC promotes ‘promiscuous behaviour’ (aOR =0.20; 95% CI: 0.07–0.61), and that sexual sensitivity is the ‘same’ regardless of circumcisionstatus, were associated with not being circumcised (aOR = 0.13; 95% CI: 0.02–0.80).Conclusion: Students had adequate knowledge about the safety of medical circumcision,and the subsequent risk reduction of HIV infection. Interventions aimed at addressingnegative sexual perceptions about circumcision may increase VMMC coverage amongcollege students.