Behavior Change Pathways to Voluntary Medical Male Circumcision: Narrative Interviews with Circumcision Clients in Zambia

January 2015 - Behavioral Prevention

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Price, J. E., Phiri, L., Mulenga, D, et al. PLoS ONE (November 2014), Vol. 9, No. 11, e111602.

This qualitative study showed that tailored messages, delivered by an appropriate "messenger," are critical to the acceptance of voluntary medical male circumcision (VMMC). The authors interviewed a sample of 40 married and unmarried men over age 18 in two VMMC clinics in Lusaka, Zambia to understand how these men first became interested in circumcision, what brought them to the VMMC clinic, and whether the medical sector met their needs. At the two high-volume clinics (>30 VMMC services daily), the authors conducted interviews in line with the Stages of Change behavioral theory to document the men’s VMMC-seeking behavior from the time they first learned about adult circumcision to the time when they entered the medical facility to seek the procedure. A major finding was that the messenger was as important as the message in the decision-making process. The interviews showed that messages about VMMC play an important role on men's behavior change; but the men also expressed the need for messages tailored to their specific needs and concerns about VMMC. Also, their frequent reference to peers and friends underscored that peer-to-peer messages play an important role in behavior change. The interviewees stressed that clinics should avoid turning men away (due to lack of supplies, for example), since this may discourage some men from returning to the clinic.

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