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Female Partner Acceptance as a Predictor of Men’s Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project

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Abstract

The World Health Organization has recommended the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in sub-Saharan Africa; however, men are often uninterested in undergoing VMMC. The Spear & Shield project enrolled 668 men and female partners from ten Zambian community health centers into parallel interventions promoting VMMC for HIV prevention or time-matched control conditions. A mediation model was utilized to examine the relationships between changes in women’s acceptance of VMMC and men’s readiness to undergo the procedure. Results demonstrated that, at 12 months post-intervention, a 5.9 % increase in the likelihood of undergoing VMMC among men in the experimental condition could be attributed to increased women’s acceptance. From a public health perspective, involving women in VMMC promotion interventions such as the Spear & Shield project could significantly impact the demand for VMMC in Zambia.

Resumen

La Organización Mundial de la Salud (OMS) ha recomendado la ampliación de la circuncisión masculina médica voluntaria (CMMV) para la prevención del VIH en el África subsahariana. Sin embargo, los hombres frecuentemente muestran desinterés en someterse al procedimiento. El proyecto Spear & Shield registro a 668 hombres y sus parejas femeninas, quienes provenían de 10 centros comunitarios de salud en Zambia en intervenciones paralelas que promueven la CMMV para la prevención del VIH. Un modelo de mediación se utilizó para examinar las relaciones entre los cambios en aceptación de CMMV en las parejas femeninas y la disposición de los hombres en someterse a la CMMV. Los resultados demostraron que, 12 meses después de la intervención, un aumento del 5.9 % en la probabilidad de someterse a la CMMV podría atribuirse a un aumento en la aceptación de CMMV de parte de las mujeres. Desde una perspectiva de salud pública, incluir a las mujeres en las intervenciones de promoción de la CMMV, como en el proyecto Spear & Shield, puede impactar substancialmente la aceptación de CMMV en Zambia.

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Acknowledgments

This study was supported by the National Institutes of Health, Grant number R01MH095539.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Tower, 1400 NW 10th Ave. Suite 404A, Miami, FL, 33136, USA

    Ryan Cook, Deborah Jones & Stephen M. Weiss

  2. Cancer Prevention Research Center, University of Rhode Island, Kingston, RI, USA

    Colleen A. Redding

  3. University of Zambia Teaching Hospital, Lusaka, Zambia

    Robert Zulu & Ndashi Chitalu

Authors
  1. Ryan Cook
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  2. Deborah Jones
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  3. Colleen A. Redding
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  4. Robert Zulu
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  5. Ndashi Chitalu
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  6. Stephen M. Weiss
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Correspondence to Ryan Cook.

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Cook, R., Jones, D., Redding, C.A. et al. Female Partner Acceptance as a Predictor of Men’s Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project. AIDS Behav 20, 2503–2513 (2016). https://doi.org/10.1007/s10461-015-1079-x

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