Acceptability of early infant male circumcision among Chinese parents: strategy implications of HIV prevention for China

Lianjun Pan, Aixia Zhang, Rong Shen, Zhong Wang, Lianjun Pan, Aixia Zhang, Rong Shen, Zhong Wang

Abstract

Background: Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC) is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China.

Methods: Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son.

Results: Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1-5 with "1" being "reluctantly agree" and "5" being "very strongly agree"). The major reason for EIMC was for health (44.8%), followed by doctor's advice (31.2%). The major reason not to agree to EIMC was concern about pain (50.5%), followed by the risk of the procedure (23.5%).

Conclusion: The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

References

    1. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med. 2005;2(11):e298. doi: 10.1371/journal.pmed.0020298.
    1. Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CF, Campbell RT, Ndinya-Achola JO. Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. Lancet. 2007;369:643–656. doi: 10.1016/S0140-6736(07)60312-2.
    1. Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton LH, Chaudhary MA, Chen MZ, Sewankambo NK, Wabwire-Mangen F, Bacon MC, Williams CF, Opendi P, Reynolds SJ, Laeyendecker O, Quinn TC, Wawer MJ. Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial. Lancet. 2007;369:657–666. doi: 10.1016/S0140-6736(07)60313-4.
    1. WHO/UNAIDS. New data on male circumcision and HIV prevention: policy and programme implications. Montreux: WHO/UNAIDS; 2007.
    1. Wiswell TE, Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83:1011–1015.
    1. El Bcheraoui C, Greenspan J, Kretsinger K, Chen R. Rates of selected neonatal male circumcision associated severe adverse events in the United States, 2007–2009. 18. Vienna: International AIDS Conference; 2010.
    1. Kalichman SC. Neonatal circumcision for HIV prevention: Cost, culture, and behavioral considerations. PLoS Med. 2010;7:e1000219. doi: 10.1371/journal.pmed.1000219.
    1. Plank RM, Makhema J, Kebaabetswe P, Hussein F, Lesetedi C, Halperin D, Bassil B, Shapiro R, Lockman S. Acceptability of Infant male circumcision as part of HIV prevention and male reproductive health efforts in Gaborone, Botswana, and surrounding areas. AIDS Behav. 2010;14:1198–1202. doi: 10.1007/s10461-009-9632-0.
    1. Mavhu W, Hatzold K, Laver SM, Sherman J, Tengende BR, Mangenah C, Langhaug LF, Hart G, Cowan FM. Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective. PLoS One. 2012;7(2):e32475. doi: 10.1371/journal.pone.0032475.
    1. Mavhu W, Buzdugan R, Langhaug LF, Hatzold K, Benedikt C, Sherman J, Laver SM, Mundida O, Woelk G, Cowan FM. Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe. Trop Med Int Health. 2011;16(5):589–597. doi: 10.1111/j.1365-3156.2011.02744.x.
    1. Wang N, Wang L, Wu Z, Guo W, Sun X, Poundstone K, Wang Y. Estimating the number of people living with HIV/AIDS in China: 2003–09. Int J Epidemiol. 2010;39(Suppl2):ii21–ii28.
    1. JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS) (accessed July 12, 2011)
    1. Albero G, Castellsagué X, Giuliano AR, Bosch FX. Male circumcision and genital human papillomavirus: a systematic review and meta-analysis. Sex Transm Dis. 2012;39(2):104–113. doi: 10.1097/OLQ.0b013e3182387abd.
    1. Ben KL, Xu JC, Lu L, Yao JP, Min XD, Li WY, Tao J, Wang J, Li JJ, Cao XM. Promoting male circumcision in China for preventing HIV infection and improving reproductive health. Zhonghua Nan Ke Xue. 2008;14:291–297.
    1. Morris BJ. Why circumcision is a biomedical imperative for the 21(st) century. Bioessays. 2007;29:1147–1158. doi: 10.1002/bies.20654.
    1. Christakis DA, Harvey E, Zerr DM, Feudtner C, Wright JA, Connell FA. A trade-off analysis of routine newborn circumcision. Pediatrics. 2000;105:246–249.
    1. Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates, infants and children: a systematic review. BMC Urol. 2010;10:2. doi: 10.1186/1471-2490-10-2.
    1. Oh SJ, Kim KD, Kim KM, Kim KS, Kim KK, Kim JS, Kim HG, Woo YN, Yoon YL, Lee SD, Han SW, Lee SI, Choi H. Knowledge and attitudes of Korean parents towards their son’s circumcision: a nationwide questionnaire study. BJU Int. 2002;89:426–432. doi: 10.1046/j.1464-4096.2001.01964.x.
    1. Waters E, Stringer E, Mugisa B, Temba S, Bowa K, Linyama D. Acceptability of neonatal male circumcision in Lusaka, Zambia. AIDS Care. 2012;24:12–19. doi: 10.1080/09540121.2011.587508.
    1. Ridings H, Amaya M. Male neonate circumcision: an evidence-based review. JAAPA. 2007;20:32–34. 36.
    1. Gee WF, Ansell JS. Neonate circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics. 1976;58:824–827.
    1. Binagwaho A, Pegurri E, Muita J, Bertozzi S. Male circumcision at different ages in Rwanda: a cost-effectiveness study. PLoS Med. 2010;7:e1000211. doi: 10.1371/journal.pmed.1000211.
    1. Westercamp N, Bailey RC. Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: a review. AIDS Behav. 2007;11:341–355. doi: 10.1007/s10461-006-9169-4.
    1. Madhivanan P, Krupp K, Chandrasekaran V, Karat SC, Reingold AL, Klausner JD. Acceptability of male circumcision among mothers with male children in Mysore, India. AIDS. 2008;22:983–988. doi: 10.1097/QAD.0b013e3282ffde52.
    1. Gust DA, Kretsinger K, Gaul Z, Pals S, Heffelfinger JD, Begley E, Chen RT, Kilmarx PH. Acceptability of newborn circumcision to prevent HIV infection in the United States. Sex Transm Dis. 2011;38:536–542.
    1. Tieu HV, Phanuphak N, Ananworanich J, Vatanparast R, Jadwattanakul T, Pharachetsakul N, Mingkwanrungrueng P, Buajoom R, Teeratakulpisarn S, Teeratakulpisarn N, Methajittiphun P, Hammer SM, Ann Chiasson M, Phanuphak P. Acceptability of male circumcision for the prevention of HIV among high-risk heterosexual men in Thailand. Sex Transm Dis. 2010;37:352–355.

Source: PubMed

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