Effect of Community Dialogue on Self-Initiated Voluntary Medical Male Circumcision (VMMC) and Uptake of HIV Voluntary Counseling and Testing (VCT) among Male Residents of Homa-Bay County, Kenya
Abstract:
Background: Voluntary medical male circumcision
(VMMC) reduces transmission of HIV by about 60%. The WHO and UNAIDS recommended
it as a new HIV prevention intervention. Counties in western Kenya region which
are predominantly occupied by a traditionally non-circumcising Luo ethnic community
have low uptake of VMMC. Homa-Bay County leads in HIV and AIDS scourge, thus requires
an intervention.
Methodology: Community dialogue, an interactive
participatory communication has not been applied to support VMMC in Homa-Bay County.
In a longitudinal
study, the effect of community dialogue
on self-initiated VMMC and uptake of HIV voluntary counseling and testing (VCT)
was determined in male residents (aged 18-49 years) resident in Homa-Bay County, Kenya. Baseline (before intervention) and endline
(after intervention) information were collected to capture the VMMC and VCT status.
Total number counts accessing VCT and VMMC services were used to assess the effect
of dialogue on the uptake of VMMC and VCT
services.
Results: Following community dialogue, males accessing VMMC services was generally
increased: from 829 (January, 2018), 1695 (February, 2018), 815 (March, 2018) and
finally 3600 (April, 2018) while for VCT services: from 360 (January, 2018), 1281
(February, 2018), 615 (March, 2018) and finally 1729 (April, 2018). For both VMMC
and VCT, there was a positive increment on the numbers of males accessing the services
following intervention.
Conclusion: Since community dialogue is an effective intervention and increases
the number of males in accessing VMMC and VCT services, it can be used as an intervention
in the prevention of HIV infection.
Keywords: VMMC, VCT, community acceptability, HIV and AIDS.
References:
[1].
Ashengo, T.A., Hatzold, K.,
Mahler, H., Rock, A., Kanagat, N., and Magalona, S. (2012). Voluntary medical
male circumcision (VMMC) in Tanzania and Zimbabwe: service delivery intensity
and modality and their influence on the age of clients. PLoS One 9, e83642.
[2].
Coates, T.J., Richter, L., and
Caceres, C. (2008). Behavioural strategies to reduce HIV transmission: how to
make them work better. Lancet 372, 669-684.
[3].
Exner, T.M., Hoffman, S.,
Parikh, K., Leu, C.S., and Ehrhardt, A. (2002). HIV counseling and testing:
women's experiences and the perceived role of testing as a prevention strategy.
Perspectives on sexual and reproductive health 34, 76-83.
[4].
FHI (2005). Family Health
International (FHI). (2005). Service Delivery Models for HIV Counseling and
Testing, FHI, Washington, DC, USA, 2005.
[5].
Gilbert, L., and Walker, L.
(2010). 'My biggest fear was that people would reject me once they knew my
status...': stigma as experienced by patients in an HIV/AIDS clinic in
Johannesburg, South Africa. Health & social care in the community 18,
139-146.
[6].
Govindasamy, D., Ford, N., and
Kranzer, K. (2012). Risk factors, barriers and facilitators for linkage to
antiretroviral therapy care: a systematic review. Aids 26, 2059-2067.
[7].
KAIS (2007). National AIDS and
STI Control Program (NASCOP) Ministry of Health, Kenya) Kenya AIDS Indicator
Survey; 2007.
[8].
KAIS (2012). National AIDS and
STI Control Programme. Kenya AIDS Indicator Survey 2012: Final Report. Nairobi,
Kenya: NASCOP, 2014.
[9].
KDHS (2008-2009). Kenya
National Bureau of Statistics. Kenya Demographic and Health Survey. 2008-2009.
[10].
Kincaid, D.L. (1987). The
convergence theory of communication, self-organization, and cultural evolution.
In D. L. Kincaid (Ed.), Communication theory: Eastern and western perspectives
New York, NY: Academic Press., 209-221.
[11].
Kincaid, D.L. (2004). From
innovation to social norm: bounded normative influence. Journal of health
communication 9 Suppl 1, 37-57.
[12].
Kundi, G.J., Mphuru, L.,
McMahan, J., Mwakipesile, P., Mwanasalli, S., and Simbeye, D. (2013). Increased
uptake of voluntary medical male circumcision (VMMC) services among older men
following mobile technology demand creation in Shinyanga and Simiyu, Tanzania.
-ISDS 2013; 2013.
[13].
Martin, S.L., Muhomah, T.,
Thuita, F., Bingham, A., and Mukuria, A.G. (2015). What motivates maternal and
child nutrition peer educators? Experiences of fathers and grandmothers in
western Kenya. Social science & medicine 143, 45-53.
[14].
Murdock, G.P. (1956). How
culture changes. In H. L. Shapiro (Ed.), Man, culture, and society (pp.
247–260). New York, NY: Oxford University Press.
[15].
Ngetich, A., Abon'go, B.,
Okomo, G., and Ouma, C. (2018). 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. Texila International
Journal.
[16].
Njeuhmeli, E., Forsythe, S.,
Reed, J., Opuni, M., Bollinger, L., Heard, N., Castor, D., Stover, J., Farley,
T., Menon, V., and Hankins, C. (2011). Voluntary medical male circumcision:
modeling the impact and cost of expanding male circumcision for HIV prevention
in eastern and southern Africa. PLoS Med 8, e1001132.
[17].
Noelle-Neumann, E. (1974). The
spiral of silence: A theory of public opinion. Journal of Communication 24,
43–51.
[18].
Noelle-Neumann, E. (2014).
Public opinion and social control. In W. Donsbach, C. Salmon, & Y. Tsfati
(Eds.), The spiral of silence: New perspectives on communication and public
opinion. New York, NY: Routledge., 19-32.
[19].
Ochieng, B., Akunja, E.,
Edwards, N., Mombo, D., Marende, L., and Kaseje, D.C. (2014). Perceptions of
health stakeholders on task shifting and motivation of community health workers
in different socio demographic contexts in Kenya (nomadic, peri-urban and rural
agrarian). BMC health services research 14 Suppl 1, S4.
[20].
Sanjobo, N., Frich, J.C., and
Fretheim, A. (2008). Barriers and facilitators to patients' adherence to
antiretroviral treatment in Zambia: a qualitative study. SAHARA J: journal of
Social Aspects of HIV/AIDS Research Alliance 5, 136-143.
[21].
Scheufele, D.A., and Moy, P.
(2000). Twenty-five years of the spiral of silence: A conceptual review and empirical
outlook. International Journal of Public Opinion Research 12, 3-28.
[22].
TACAIDS (. 2013). TACAIDS,
ZAC, NBS, OCGS, International I. (2013). Tanzania HIV/AIDS and malaria
indicator survey 2011-12: key findings. Dar es Salaam, Tanzania: National
Bureau of Statistics, Ministry of Finance; 2013.
[23].
UNAIDS, W.a. (2016). A
framework for voluntary medical male circumcision: VMMC 2021 [Internet]. 2016.
[cited 2017 December 30th]. Available from:
http://www.who.int/hiv/pub/malecircumcision.
[24].
Underwood, C., Brown, J.,
Sherard, D., and Abdur-Rahman, A. (2011). Reconstructing gender norms through
ritual communication: A study of African Transformation. Journal of
Communication 61, 197-218.
[25].
Wachira, J., Kimaiyo, S.,
Ndege, S., Mamlin, J., and Braitstein, P. (2012). What is the impact of
home-based HIV counseling and testing on the clinical status of newly enrolled
adults in a large HIV care program in Western Kenya? Clinical infectious
diseases: an official publication of the Infectious Diseases Society of America
54, 275-281.
[26].
Wegs, C., Creanga, A.A.,
Galavotti, C., and Wamalwa, E. (2016). Community Dialogue to Shift Social Norms
and Enable Family Planning: An Evaluation of the Family Planning Results
Initiative in Kenya. PloS one 11, e0153907.
[27].
WHO (2007). WHO, UNAIDS. (2007).
New data on male circumcision and HIV prevention (2007): policy and program
implications. WHO/UNAIDS technical consultation on male circumcision and HIV
prevention: research implications for policy and programming. WHO meeting
Montreux, Switzerland. .
[28].
WHO (2015). WHO (2015). WHO
progress brief voluntary medical male circumcision for HIV prevention in 14
priority countries in East and Southern Africa. Geneva, Switzerland: WHO; 2015.