Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling

Anderson Bendera, Keiko Nakamura, Kaoruko Seino, Saber Al-Sobaihi Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, JapanCorrespondence: Keiko Nakamura, Department of Global Health Entrepreneurship, Division of Public Health, Tokyo M...

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Main Authors: Bendera A, Nakamura K, Seino K, Al-Sobaihi S
Format: Article
Language:English
Published: Dove Medical Press 2022-12-01
Series:HIV/AIDS: Research and Palliative Care
Subjects:
Online Access:https://www.dovepress.com/factors-associated-with-low-uptake-of-medical-male-circumcision-among--peer-reviewed-fulltext-article-HIV
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author Bendera A
Nakamura K
Seino K
Al-Sobaihi S
author_facet Bendera A
Nakamura K
Seino K
Al-Sobaihi S
author_sort Bendera A
collection DOAJ
description Anderson Bendera, Keiko Nakamura, Kaoruko Seino, Saber Al-Sobaihi Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, JapanCorrespondence: Keiko Nakamura, Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan, Tel +81 3-5803-4048, Fax +81-3-5803-4034, Email nakamura.ith@tmd.ac.jpBackground: Human immunodeficiency virus (HIV) remains the leading cause of years of life lost among adolescent boys in eastern and southern Africa. Medical male circumcision (MMC) is a cost-effective one-time intervention that can reduce the risk of heterosexual HIV acquisition in men by approximately 60%. Despite its importance in HIV prevention, the uptake of MMC remains suboptimal among adolescent boys. This study aimed to identify factors associated with low MMC uptake among adolescent boys in Tanzania.Methods: This study was a secondary analysis of the 2016– 17 Tanzania HIV Impact Survey. Descriptive statistics were used to summarize the participants’ characteristics. Unadjusted and adjusted multinomial logistic regression models were fitted to identify factors associated with low MMC uptake among adolescent boys.Results: A total of 2605 older adolescents (15– 19 years) and 1296 young adolescents (10– 14 years) were analyzed. The MMC uptake rates among older and young adolescents were 56.5% and 45.1%, respectively. Lower MMC uptake was found among respondents in rural areas (adjusted relative risk ratio [aRRR] = 0.40, 95% CI: 0.28– 0.57), in the traditionally non-circumcising zone (aRRR = 0.30, 95% CI: 0.23– 0.41), participants with no formal education (aRRR = 0.32, 95% CI: 0.23– 0.41), and those living in lower wealth quintile households (aRRR = 0.20, 95% CI: 0.11– 0.36). Respondents who were not covered by health insurance (aRRR = 0.67, 95% CI: 0.48– 0.94) and those who had no comprehensive HIV knowledge (aRRR = 0.55, 95% CI: 0.44– 0.70) were also found to have lower uptake of MMC.Conclusion: To achieve and maintain high MMC coverage, MMC interventions for HIV prevention should focus on uncircumcised adolescent boys who are rural residents, of lower socioeconomic status, and residing in traditionally non-circumcising communities. Furthermore, dissemination of HIV knowledge and increasing health insurance coverage may encourage more adolescent boys to undergo MMC.Keywords: adolescent boys, HIV prevention, medical male circumcision, Tanzania
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spelling doaj.art-1fe80e45b07045f9ab813136cb6123642022-12-22T04:42:19ZengDove Medical PressHIV/AIDS: Research and Palliative Care1179-13732022-12-01Volume 1456557580433Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression ModelingBendera ANakamura KSeino KAl-Sobaihi SAnderson Bendera, Keiko Nakamura, Kaoruko Seino, Saber Al-Sobaihi Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, JapanCorrespondence: Keiko Nakamura, Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan, Tel +81 3-5803-4048, Fax +81-3-5803-4034, Email nakamura.ith@tmd.ac.jpBackground: Human immunodeficiency virus (HIV) remains the leading cause of years of life lost among adolescent boys in eastern and southern Africa. Medical male circumcision (MMC) is a cost-effective one-time intervention that can reduce the risk of heterosexual HIV acquisition in men by approximately 60%. Despite its importance in HIV prevention, the uptake of MMC remains suboptimal among adolescent boys. This study aimed to identify factors associated with low MMC uptake among adolescent boys in Tanzania.Methods: This study was a secondary analysis of the 2016– 17 Tanzania HIV Impact Survey. Descriptive statistics were used to summarize the participants’ characteristics. Unadjusted and adjusted multinomial logistic regression models were fitted to identify factors associated with low MMC uptake among adolescent boys.Results: A total of 2605 older adolescents (15– 19 years) and 1296 young adolescents (10– 14 years) were analyzed. The MMC uptake rates among older and young adolescents were 56.5% and 45.1%, respectively. Lower MMC uptake was found among respondents in rural areas (adjusted relative risk ratio [aRRR] = 0.40, 95% CI: 0.28– 0.57), in the traditionally non-circumcising zone (aRRR = 0.30, 95% CI: 0.23– 0.41), participants with no formal education (aRRR = 0.32, 95% CI: 0.23– 0.41), and those living in lower wealth quintile households (aRRR = 0.20, 95% CI: 0.11– 0.36). Respondents who were not covered by health insurance (aRRR = 0.67, 95% CI: 0.48– 0.94) and those who had no comprehensive HIV knowledge (aRRR = 0.55, 95% CI: 0.44– 0.70) were also found to have lower uptake of MMC.Conclusion: To achieve and maintain high MMC coverage, MMC interventions for HIV prevention should focus on uncircumcised adolescent boys who are rural residents, of lower socioeconomic status, and residing in traditionally non-circumcising communities. Furthermore, dissemination of HIV knowledge and increasing health insurance coverage may encourage more adolescent boys to undergo MMC.Keywords: adolescent boys, HIV prevention, medical male circumcision, Tanzaniahttps://www.dovepress.com/factors-associated-with-low-uptake-of-medical-male-circumcision-among--peer-reviewed-fulltext-article-HIVadolescent boyshiv preventionmedical male circumcisiontanzania
spellingShingle Bendera A
Nakamura K
Seino K
Al-Sobaihi S
Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling
HIV/AIDS: Research and Palliative Care
adolescent boys
hiv prevention
medical male circumcision
tanzania
title Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling
title_full Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling
title_fullStr Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling
title_full_unstemmed Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling
title_short Factors Associated with Low Uptake of Medical Male Circumcision Among Adolescent Boys in Tanzania: A Multinomial Logistic Regression Modeling
title_sort factors associated with low uptake of medical male circumcision among adolescent boys in tanzania a multinomial logistic regression modeling
topic adolescent boys
hiv prevention
medical male circumcision
tanzania
url https://www.dovepress.com/factors-associated-with-low-uptake-of-medical-male-circumcision-among--peer-reviewed-fulltext-article-HIV
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