Perceptions and factors associated with uptake of voluntary medical male circumcision among boda-boda riders aged 18-49 years in Hoima municipality, Hoima district.

Abstract

Introduction: Voluntary medical male circumcision (VMMC) has been indicated to reduce the risk of HIV/AIDS sexual transmission from infected women to men by around 60%. The ministry of health in Uganda adopted a policy on VMMC in 2010. However, uptake of VMMC has constantly remained far below the set targets. Objective: To explore perceptions of and determine factors associated with the uptake of voluntary medical male circumcision (VMMC) among boda-boda riders in Hoima Municipality, Hoima district. Methods: This was a cross-sectional study employing a mixed methods data collection approach. A total of 8 FGDs and 6 key informant interviews were conducted for the qualitative data collection. A sample size of 316 boda-boda riders was recruited for the quantitative data. Purposive sampling and multilevel sampling techniques were employed for the qualitative and quantitative data respectively. Qualitative data were analyzed using Atlas Ti version 6 and results are presented under different themes. Quantitative data were analyzed using STATA version 14; Univariate, bivariate and multivariate analysis were conducted and results are presented using measures of central tendency, dispersion and associations. Results: Overall, boda-boda riders understood the availability and benefits of VMMC services. Major facilitators of VMMC were improved penile hygiene, reduced chances of HIV and STIs; and improved sexual practices. Barriers and misconceptions about VMMC were fear of pain, fear of HIV testing, long healing time, promotion of promiscuity, interruption of God’s creation and loss of manpower. Prevalence of VMMC was 33.9% and was positively associated with secondary education; APR 1.44 [1.04-2.01], rejection of the belief that circumcision diminishes a man’s sexual performance; APR 2.06 [1.24-3.41] and not having any sexual partner(s); APR 1.27 [1.08- 2.00]. Conclusion: Availability and health benefits of VMMC were generally understood. However, prevalence of VMMC was low. There is need for population specific interventions among bodaboda riders to address the barriers and misconceptions of VMMC. Interventions like targeted counselling, use of outreaches and compensation strategies during the healing process need to be implemented.