MAKING A DIFFERENCE IN PEOPLE'S LIVES 16 th ICASA CONFERENCE 4-8 th December Millennium Hall, Addis Ababa- Ethiopia Attitudes and Acceptability of Male Circumcision: One Year after Launch of the National Male Circumcision Policy in Uganda Presenter: Robert Nangai Co-authors: Esther Kaggwa, Simon Ndizeye, Cheryl Lettenmaier, Ruth Museruka Health Communication Partnership

MAKING A DIFFERENCE IN PEOPLE'S LIVES Overview 1.2 million Ugandans living with HIV Over 130,000 new infections every year MC reduces the risk of HIV infection by 60% 25% of Ugandans currently circumcised Circumcising 4.2 million men in 5 years can avert 400,000 new infections Limited locations where MMC is available

MAKING A DIFFERENCE IN PEOPLE'S LIVES MMC Communication

MAKING A DIFFERENCE IN PEOPLE'S LIVES Study Methodology Household survey in 31 districts November – December, 2010 Interviewed 2,896 individuals aged years Multi stage stratified sampling for young people aged and adults Objectives: To evaluate the reach and effects of HCP supported communication activities To provide baseline measures for new communication activities

MAKING A DIFFERENCE IN PEOPLE'S LIVES Respondent Characteristics Characteristics NumberPercentage No. of respondents2,896 Male Female 1,379 1, ,483 1, Rural Urban 2, Non-circumcising culture2, % were aware of Uganda MC Policy 21% of males had been circumcised (84% circumcised as babies) 42% reported that their community approves of MC

MAKING A DIFFERENCE IN PEOPLE'S LIVES 45% exposed Males from urban areas with secondary of higher education more likely to be exposed Exposure to MMC Messages N = 2896 All P < 0.05

MAKING A DIFFERENCE IN PEOPLE'S LIVES Knowledge of a Place Offering Medical Male Circumcision Services N = 2,795All P < 0.05

MAKING A DIFFERENCE IN PEOPLE'S LIVES Percent of Men & Women who Said Male Circumcision is Harmful N = % thought MC is harmful Rural, aged years, lower SES, & primary or lower education more likely to say MC is harmful n = 402

MAKING A DIFFERENCE IN PEOPLE'S LIVES Percent of Men & Women who Said Male Circumcision is Beneficial N = % said MC is beneficial N = 2,082

MAKING A DIFFERENCE IN PEOPLE'S LIVES Variable Odds ratio Education level Primary and below (ref) 1 Secondary and above 1.6 Exposure to MC messages Not exposed to MC messages (ref)1 Exposed to MC messages3.8 Age years (ref) years2.6 Others Marital status**1.23 Residence**0.86 Sexual activity**1.17 **Not associated with intention to circumcise Factors Associated with Intention to Circumcise (Multivariate) N = 1,041

MAKING A DIFFERENCE IN PEOPLE'S LIVES Conclusions & Recommendations Knowledge of a place offering MMC low High level of acceptance for MMC Exposure to MMC messages strongly associated with intention to circumcise Married, older men significantly less likely to intend to circumcise MMC communication should focus on older married men & identify services

MAKING A DIFFERENCE IN PEOPLE'S LIVES Acknowledgements Ministry of Health MC Working Group HCP MUSPH USAID