TY - JOUR
T1 - Increasing early infant male circumcision uptake in Zambia
T2 - Like father like son
AU - Weiss, Stephen M.
AU - Rodriguez, Violeta J.
AU - Cook, Ryan R.
AU - Bowa, Kasonde
AU - Zulu, Robert
AU - Mweemba, Oliver
AU - Kamboyi, Royd
AU - Castro, Jose
AU - Dunleavy, Victoria Orrego
AU - Alcaide, Maria L.
AU - Jones, Deborah L.
N1 - This study was funded by the National Institutes of Health/National Institute of Mental Health (NIH/NIMH; R34MH121111 and R01MH095539), with support from the University of Miami Miller School of Medicine Center for AIDS Research funded by NIH/National Institute of Allergy and Infectious Diseases (NIAID) (P30AI073961). VJR’s work on this study was also supported by a Ford Foundation Fellowship, administered by the National Academies of Sciences, Engineering, and Medicine (NASEM), a PEO Scholar Award from the PEO Sisterhood, and NIMH R36MH127838. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
PY - 2023/8
Y1 - 2023/8
N2 - Voluntary Medical Male Circumcision (VMMC) is an effective strategy for HIV prevention in areas with high prevalence of, and risk for, HIV. More than 361,000 male neonates are born each year in Zambia, many of whom could be eligible for Early-Infant Medical Circumcision (EIMC). Building on successful implementation strategies utilized in our Spear & Shield program, this pilot study, “Like Father, Like Son” (LFLS), evaluated the feasibility and acceptability of offering combined EIMC and VMMC services and couple-level behavioral interventions. A total of N = 702 pregnant women and their male partners (n = 351 couples) were recruited and enrolled. Couples were assessed twice pre-birth, 2 weeks post birth, and 6 months post birth. Expectant mothers were an average of 15.05 weeks pregnant (SD = 8.83). Thirty-nine pregnancies did not result in a live birth (11%), 14 couples withdrew from the study or were lost to follow-up prior to delivery (4%), and 148 babies were born female (42%), leaving 150 couples with a male infant in the analytic sample (43%). The LFLS study achieved significantly higher EIMC rates (35%) in comparison with previously observed EIMC study rates in Zambia (11%), and significantly higher than hypothetical comparison rates up to 30%. Relative to baseline rates, odds of VMMC among couples’ older sons increased by 31% at post-intervention and by 90% at two-weeks following birth. Overall, this pilot study found the LFLS intervention to be feasible, acceptable, and effective in doubling the rate of EIMC in comparison with a previous longitudinal study in Zambia. Future research should consider a family-centric approach to promotion of male circumcision for infants and adolescents. LFLS may be effective in promoting father-son “bonding” by MC status; a bond that may be a bridge to increase both EIMC and VMMC uptake in newborns and couples’ older sons and is a novel leverage point for promotion of this HIV prevention strategy.
AB - Voluntary Medical Male Circumcision (VMMC) is an effective strategy for HIV prevention in areas with high prevalence of, and risk for, HIV. More than 361,000 male neonates are born each year in Zambia, many of whom could be eligible for Early-Infant Medical Circumcision (EIMC). Building on successful implementation strategies utilized in our Spear & Shield program, this pilot study, “Like Father, Like Son” (LFLS), evaluated the feasibility and acceptability of offering combined EIMC and VMMC services and couple-level behavioral interventions. A total of N = 702 pregnant women and their male partners (n = 351 couples) were recruited and enrolled. Couples were assessed twice pre-birth, 2 weeks post birth, and 6 months post birth. Expectant mothers were an average of 15.05 weeks pregnant (SD = 8.83). Thirty-nine pregnancies did not result in a live birth (11%), 14 couples withdrew from the study or were lost to follow-up prior to delivery (4%), and 148 babies were born female (42%), leaving 150 couples with a male infant in the analytic sample (43%). The LFLS study achieved significantly higher EIMC rates (35%) in comparison with previously observed EIMC study rates in Zambia (11%), and significantly higher than hypothetical comparison rates up to 30%. Relative to baseline rates, odds of VMMC among couples’ older sons increased by 31% at post-intervention and by 90% at two-weeks following birth. Overall, this pilot study found the LFLS intervention to be feasible, acceptable, and effective in doubling the rate of EIMC in comparison with a previous longitudinal study in Zambia. Future research should consider a family-centric approach to promotion of male circumcision for infants and adolescents. LFLS may be effective in promoting father-son “bonding” by MC status; a bond that may be a bridge to increase both EIMC and VMMC uptake in newborns and couples’ older sons and is a novel leverage point for promotion of this HIV prevention strategy.
UR - https://www.scopus.com/pages/publications/85167672203
UR - https://www.scopus.com/pages/publications/85167672203#tab=citedBy
U2 - 10.1371/journal.pone.0289819
DO - 10.1371/journal.pone.0289819
M3 - Article
C2 - 37561707
AN - SCOPUS:85167672203
SN - 1932-6203
VL - 18
JO - PloS one
JF - PloS one
IS - 8 August
M1 - e0289819
ER -