Soccer-Based Promotion of Voluntary Medical Male Circumcision: A Mixed-Methods Feasibility Study with Secondary Students in Uganda
Miiro, G., DeCelles, J., Rutakumwa, R., et al. PLOS ONE (October 2017), 12 (10), doi:e0185929.
This study examined the feasibility of a soccer program to impart voluntary medical male circumcision (VMMC) messages to school-aged boys in Uganda. The authors used surveys and in-depth interviews to examine knowledge and attitudes about VMMC. The pilot intervention included a coach who shared stories about his decision to become circumcised and the protective benefits of VMMC. Coaches also accompanied boys who chose VMMC to the procedure. Among the 58 boys exposed to the first intervention, 41 percent reported interest in VMMC, and 10 percent had a circumcision. Challenges included difficulty receiving parental consent, low attendance (since the program was only available after school), and timing, because most boys preferred to undergo VMMC during school holidays. Based on these findings, coaches made home visits to educate parents, and made arrangements to implement the intervention during school hours and just before the holidays. Following the adapted program intervention, 55 percent expressed interest in VMMC and 23 percent had a circumcision. Qualitative results demonstrated that although the attitudes of family and friends toward VMMC were important, coaches strongly influenced the decision to be circumcised. Reasons for circumcision included improved hygiene and reduced HIV risk. Fear was the principal deterrent. The authors concluded that the adapted intervention is time-intensive, but may significantly influence uptake of VMMC.