Communication-related factors influencing the uptake of voluntary medical male circumcision among men in Lilongwe Urban, Malawi

Abstract

Voluntary Medical Male Circumcision (VMMC) has been promoted as an effective biomedical intervention in the reduction of the risk of new HIV and STI infections. The government of Malawi and its stakeholders including the World Health Organization have committed a lot of resources to VMMC programming. However, research shows that its uptake among men is still low in Malawi. This study, therefore, investigated the communication-related factors that influence decision-making in the uptake of VMMC among men in Lilongwe, Malawi. To achieve this aim, twenty-five men, aged between 18 and 35 years old were interviewed on what influenced them to undergo VMMC. The study found that the respondents were influenced to uptake VMMC mostly by peer pressure and the need for conformity ; partner/girlfriend demand and considerations; and advice from health personnel. Voluntary Male Medical Circumcision (VMMC) is one of the effective strategies for reducing new HIV/AIDS infections. The WHO and UNAIDS recommended the inclusion of male circumcision in HIV-prevention guidelines in countries in Southern Africa, including Malawi, with low cir-cumcision rates and generalized epidemics. VMMC in Malawi was launched in 2012 with the government aiming to achieve 80% coverage among men aged 10-34 by 2020. Considering that there are more barriers than enablers of circumcision, this target of circumcising 80% of the eligible men was quite ambitious. The barriers include social and cultural factors and physical pain, whereas the benefits include improved sex, hygiene, and protection from HIV. However, when the VMMC campaign was scaled up across the country, uptake remained relatively low. It was from this background that the researchers examined the communication-related factors that influence men to uptake VMMC. The findings reported in this paper are part of ongoing studies in Behaviour Change communication being carried out by the department. Attribution (CC-BY) 4.0 license. respondents mentioned the HIV and STI infection risk reduction properties, hygienic advantages, and cervical cancer reduction properties of VMMC as benefits of VMMC, these had very little influence on their decision. It is recommended that current intervention messages be reviewed and modified to incorporate new ideas that can address the shortcomings that the current crop of messages has with the aim of increasing the uptake of VMMC programmes or other health focused behaviour change programmes.