Abstract
Background: This study explores the perceptions of men in the Shiselweni Region regarding barriers and enabling factors influencing the uptake of Voluntary Medical Male Circumcision (VMMC), a key HIV prevention strategy. As a one-time main prevention measure, VMMC involves the complete surgical removal of the foreskin, which lowers the chance of heterosexual transmission of HIV from females to males by 60% (Gray et al., 2018). HIV among males aged 18 years and above is increasing globally, with transmission predicted at between 490,000–850,000 cases globally (WHO, 2023). Through VMMC programs, 11.7 million male adolescents and adults had undergone circumcision by the end of 2015. By 2025, the 9.1 million VMMCs performed between 2008 and 2014 will have prevented around a quarter of a million HIV infections (Masese et al., 2021).
Aim: This study aimed to assess barriers and enablers for the uptake of VMMC among men aged 18-50 years in the Shiselweni Region of the kingdom of Eswatini.
Objectives: The study determined the knowledge, attitudes, and practices (KAP) regarding VMMC among men aged 18–50 in the Shiselweni Region of the kingdom of Eswatini. It also determined the barriers and enablers influencing uptake in this population, and examined the differences and correlations between sociodemographic factors and VMMC uptake among these men.
Methodology: A cross-sectional quantitative design was implemented. The study surveyed men attending three Male OPDs in the Shiselweni Region. Simple random sampling was employed from a population of 97,266 males aged 18-50 years, yielding a calculated sample size of 383 at 95% CI using EPI info (version 5.5). The sample size was then inflated by 25% for contingency reasons, giving an estimated sample size of 478 participants. Participants included resident males aged 18–50 attending OPDs who consented to participate, while females, non-residents, those <18 or >50, and non-consenting individual were excluded. An electronic, self-administered, SiSwati-translated questionnaire was piloted for reliability and subsequently used for actual data collection. Data was analysed in SPSS v29.0 using descriptive statistics, bivariate analysis, and logistic regression to explore sociodemographic predictors.