Evidence map›Paper›PMID 38820408›Full record

ArticlePLOS global public health2024

Shifting reasons for older men remaining uncircumcised: Findings from a pre- and post-demand creation intervention among men aged 25-39 years in western Kenya.

Kawango Agot, Jacob Onyango, George Otieno, Paul Musingila, Susan Gachau, Marylyn Ochillo, Jonathan Grund, Rachael Joseph, Edward Mboya, Spala Ohaga and 2 more

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kawango AgotImpact Research and Development Organization, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-6153-8950
Jacob OnyangoImpact Research and Development Organization, Kisumu, Kenya.ORCID https://orcid.org/0000-0001-7653-7902
George OtienoCenter for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-0148-222X
Paul MusingilaDivision of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya.
Susan GachauDivision of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya.
Marylyn OchilloImpact Research and Development Organization, Kisumu, Kenya.
Jonathan GrundDivision of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Pretoria, South Africa.
Rachael JosephDivision of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya.
Edward MboyaImpact Research and Development Organization, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-0582-2949
Spala OhagaImpact Research and Development Organization, Kisumu, Kenya.
Dickens OmondiJaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya.
Elijah Odoyo-JuneDivision of Global HIV and TB (DGHT), Center for Global Health (CGH), US Centers for Disease Control and Prevention, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-1370-2306

Funding

CGH CDC HHS U01 GH000518
6 · The paper itself

Abstract

Voluntary medical male circumcision (VMMC) reduces men's risk of acquiring Human immunodeficiency virus (HIV) through vaginal sex. However, VMMC uptake remains lowest among Kenyan men ages 25-39 years among whom the impact on reducing population-level HIV incidence was estimated to be greatest at the start of the study in 2014. We conducted a pre- and post-intervention survey as part of a cluster randomized controlled trial to determine the effect of two interventions (interpersonal communication (IPC) and dedicated service outlets (DSO), delivered individually or together) on improving VMMC uptake among men ages 25-39 years in western Kenya between 2014 and 2016. The study had three intervention arms and a control arm. In arm one, an IPC toolkit was used to address barriers to VMMC. In arm two, men were referred to DSO that were modified to address their preferences. Arm three combined the IPC and DSO. The control arm had standard of care. At baseline, uncircumcised men ranked the top three reasons for remaining uncircumcised. An IPC demand creation toolkit was used to address the identified barriers and men were referred for VMMC at study-designated facilities. At follow-up, those who remained uncircumcised were again asked to rank the top three reasons for not getting circumcised. There was inconsistency in ranking of reported barriers at pre- and post- intervention: 'time/venue not convenient' was ranked third at baseline and seventh at follow-up; 'too busy to go for circumcision' was tenth at baseline but second at follow-up, and concern about 'what I/family will eat' was ranked first at both baseline and follow-up, but the proportion reduced from 62% to 28%. Men ages 25-39 years cited a variety of logistical and psychosocial barriers to receiving VMMC. After exposure to IPC, most of these barriers shifted while some remained the same. Additional innovative interventions to address on-going and shifting barriers may help improve VMMC uptake among older men.

Identifiers

PMID38820408
PMCPMC11142559

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.