UPTAKE OF SAFE MALE CIRCUMCISION FOR HIV PREVENTION AMONG SEASONAL CULTIVATORS AND PASTORALISTS IN GOMBA DISTRICT, UGANDA

Abstract

Introduction Safe male circumcision (SMC) is one of the elements in comprehensive HIV care strategy in prevention of HIV transmission from an infected woman to a man, but uptake was still very low in Gomba. This study, determined prevalence of male circumcision; factors facilitating uptake of SMC among pastoralists and seasoned cultivators in Gomba. Methodology A Cross-sectional study design was used. It employed both qualitative and quantitative data collection methods. A structured questionnaire and focus group interview guides were used to collect data from the respondents. Quantitative data were analysed using STATA version 13.0. A modified Poisson regression model was used to determine the factors associated with the uptake of SMC. Thematic analysis for qualitative data came up with the presided barriers and facilitators of SMC uptake to ensure maximum output. Results Prevalence of SMC was 27 % among seasonal cultivators and pastoralists. Socio-demographic including age group above 40 (PR=28, at 95% CI, 0.15 – 0.51) method of HIV prevention (PR=79 at 95 CI, 0.1 – 0.54) and reading Newspapers (PR=44 at 95% CI, 0.2-0.8), were significantly related to SMC uptake. There was low knowledge on prevention less than 50% and SMC uptake (18%). More than half of the respondents (51.1%) had their nearest neighbors in a distance of more than 5 kms. Perceptions on SMC uptake came up as perceived facilitators as personal benefit as well as committed benefits. However, perceived barriers among the pastoralist and seasonal cultivators were presented as individual fears as pain, sepsis, Blood loss, loss of income and loss of manhood and community fears as supper situation and myths, female surgeons as well as lack of sensitization. Perceived interventions included health facility related, District Health Office as well as Community Interventions that would help improve SMC uptake. Conclusion Uptake was found to be below the national of 43%. This was due to lack of awareness on SMC uptake, indicated by variation in perceptions without scientific basis. The lack of knowledge cut across causal and perceptual factors that influenced SMC uptake. The study found the need for innovative ways to demystify negative unfounded views held on SMC by seasonal cultivators and pastoralists.