Community perception of male circumcision with reference to HIV/AIDS prevention in Nyando sub-location, Kisumu County, Kenya

Abstract

From the time HIV was discovered, efforts have been made and are still being made to control it. Prevention methods are the focus of many studies as the cure is being sought. Three randomized control trials in South Africa, Kenya and Uganda revealed that male circumcision can provide partial protection from HIV infection of up to sixty percent in males. Efforts have been made to educate the entire population on the importance of Voluntary and Informed Medical Male Circumcision (VIMMC) aimed at reducing infection by HIV in men. VIMMC services are also being provided free of charge at selected health facilities. The Luo have not been practicing circumcision. Now that circumcision has been included in the package of HIV prevention measures, is the community willing to change their culture and start circumcising their males? The present study aimed to find out the views of a non-circumcising community in western Kenya – the Luo, about circumcision for prevention of HIV infection. The overall objective of the study was to assess the response of the community in Nyando Sub location to voluntary circumcision in relation to HIV/AIDS prevention. The specific objectives of the study were: 1.To find out if the residents of Nyando sub-location were aware of the importance of Voluntary and Informed Male Circumcision for HIV prevention. 2. To find out if residents of Nyando sub-location have accepted male circumcision as a method of HIV prevention. 3. To find out if the Luo culture of not practicing circumcision is hindering the community members from accepting circumcision for HIV prevention. Sampling was done based on the results of the 2009 Population and Housing Census where Nyando sub location had a population of 2495 people, with 1277 males and 1218 females, and 480 households. The 480 households were used as the sampling frame. By use of questionnaires, data was collected from one adult male from each household in a simple random sample of 55 households. Data was also collected from one adult female per household in a simple random sample of 55 households. In total, data were collected from 110 respondents comprising 55 adult males and 55 adult females. Nyando sub location does not have a VIMMC Centre. The key informants were sampled purposively from the neighbouring health facility since Nyando Sub location does not have a health facility. analyzed for the most important responses that were in line with the hypothesis and objectives. Data from the questionnaires were coded and entered in the SPSS computer programme for analysis. Quantitative data were tabulated and presented in percentages and charts. Similar responses of qualitative data were given same numerical codes then tables of frequencies were generated. The frequencies were then presented as percentages. The study found out that the community is aware of VIMMC and its importance in the prevention of HIV and AIDS. Members of the community fully support and appreciate VIMMC can reduce the spread of HIV and AIDS. Eighty nine percent of married women would like their spouses to be circumcised for reduction of HIV infection. Ninety four percent of men with sons wanted their sons to undergo VIMMC while ninety three percent of women with sons wanted their sons to be circumcised. Ninety five percent of men interviewed supported VIMMC. At the same time fifty three percent of the men interviewed said they had been circumcised through VIMMC. However elders felt that circumcision was meant for young men who are still very active sexually. As a result, The VIMMC centres experience a number of challenges including shortage of personnel and inadequate funds. The Luo culture of not circumcising their males has not deterred them from embracing VIMMC for HIV and AIDS prevention. This study therefore recommends that more VIMMC centres should be increased and more trained personnel hired to provide the services to the high number of men seeking this service.