Abstract
Highlights Public health relevance—How does this work relate to a public health issue? • Male circumcision is a proven intervention for reducing HIV transmission, yet uptake remains suboptimal in non-circumcising communities, highlighting a critical public health gap. • Understanding knowledge, attitudes, and perceptions towards VMMC is essential for addressing behavioural barriers to HIV prevention in high-burden settings. Public health significance—Why is this work of significance to public health? • The study identifies persistent knowledge gaps and misconceptions despite high awareness, which may limit the effectiveness of VMMC programmes. • It demonstrates that education level, knowledge, and circumcision status are key determinants of favourable attitudes and perceptions, highlighting the importance of health literacy in HIV prevention. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? • Targeted, culturally appropriate health education interventions are needed to address misconceptions and improve acceptance of VMMC, particularly among rural and less-educated populations. • Strengthening community engagement strategies and integrating VMMC promotion within broader HIV prevention programmes can enhance uptake and contribute to population-level reductions in HIV transmission. Abstract Male circumcision (MC) has been shown in studies from South Africa, Kenya, and Uganda to reduce heterosexual Human Immunodeficiency Virus (HIV) transmission among men by approximately 50–60%. Despite Namibia's adoption of voluntary medical male circumci-sion (VMMC) as part of national HIV prevention strategies, uptake remains suboptimal in some communities. This study assessed the knowledge, attitudes, and perceptions (KAP) of male circumcision among men aged 20–40 years in Otjiwarongo, Namibia, and examined socio-demographic factors associated with these outcomes. A community-based cross-sectional survey was conducted between March and May 2024, involving 359 participants Int.