Community Acceptability of Voluntary Medical Male Circumcision (VMMC) as a Strategy in the Fight against the Spread of HIV and AIDS among Residents of Homa-Bay County Kenya

Abstract

Background: Voluntary medical male circumcision (VMMC) reduces female-to-male transmission of HIV by about 60% leading to the global WHO and UNAIDS recommendation of VMMC to men. A traditionally non-circumcising Luo ethnic community predominantly occupies Homa-Bay County in western Kenya where the uptake of VMMC as an intervention for prevention of HIV acquisition has been low. Community dialogue is a participatory communication process of sharing information aimed at reaching a common understanding and workable solution. The current study documented the baseline status on the acceptability of uptake of VMMC and access to voluntary counselling and testing (VCT) among residents of Homa-Bay County, Kenya prior to intervention (community dialogue). Methods: Males of Luo ethnic group, uncircumcised and aged 18-49 years drawn from 419 households were recruited. Baseline information (before intervention) were collected to capture the acceptance of VMMC, circumcision status and testing for HIV in the population. Structured and semi-structured questionnaires were used for data collection. Results: Analysis showed that in Ndhiwa, Rachuonyo North and Suba South Sub-counties, 54.9%, 84.1% and 69.8%, respectively, had accessed VCT, while 3.5%, 0.7% and 10.8%, respectively had undergone VMMC. The proportions of those who accessed VCT services were significantly higher (P<0.0001) while the proportions of those who had undergone VMMC were significantly lower (P<0.0001) across the three sub-counties. Conclusion: These results demonstrate that even though majority access VCT services to know their HIV status, significantly few men decide to undergo VMMC. This revealed a decreased acceptability of this service in Homa-Bay County prior to the intervention.