Hatzold, K., Mavhu, W., Jasi, P., et al. PLOS ONE (May 2014), 9(4): e85051, doi: 10.1371/journal.pone.0085051.
This quantitative and qualitative study explored barriers and motivating factors to voluntary medical male circumcision (VMMC) for HIV prevention in Zimbabwe, where uptake of VMMC had been slower than anticipated. The study also assessed which communication channels reached respondents with information on VMMC. Data were collected through a survey (N=2,350, 49.6% men, 50.4% women) and focus group discussions, using purposeful sampling to ensure representative ethnic and age diversity. Most had heard about VMMC for HIV prevention (68% of men; 53% of women); 71 percent of women were supportive of VMMC. Motivating factors cited by men were prevention of HIV and sexually transmitted infections (44%), improved hygiene (26%), enhanced sexual performance (6%), and cervical cancer prevention for the partner (6%). Men cited fear of pain (40%), no risk of HIV (18%), and lack of partner support (6%) as key barriers. Respondents received information on VMMC from radio (71%), TV, newspaper, billboards and posters, and interpersonal communication with community health workers and others. The authors concluded that messages to create demand for VMMC should be tailored to different ages, address men’s fear of pain, and emphasize benefits aside from HIV prevention, such as improved hygiene and sexual appeal. They also recommended greater emphasis on promoting VMMC among women who influence men’s decisions.