TP 189 Implementing Medical Male Circumcision for HIV/STI Risk Reduction: Exploring Acceptability Among Medical Care Providers in Haiti

Tuesday, June 10, 2014
Exhibit Hall
Muni Rubens, MBBS, MPH1, Anshul Saxena, MPH1, Stephanie Gaston, BS2, Michele Jean-Gilles, PhD1, Purnima Madhivanan, MBBS, MPH, PhD3 and Jessy Devieux, PhD1, 1AIDS Prevention Program, Department of Health Promotion and Disease Prevention, Florida International University, North Miami, FL, 2Les Centres GHESKIO, Les Centres GHESKIO, Port-au-Prince, Haiti, 3Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami

Background: Medical male circumcision (MMC) has been recommended by the World Health Organization to reduce risk of acquisition and transmission of sexually transmitted infections, including HIV. In order to address barriers to potentially scale up the procedure, it is important to consider health care providers’ perspectives on MMC, especially in resource limited settings.

Methods: Medical care providers (N=62) receiving training on HIV/STI treatment at the GHESKIO Centers in Port-au-Prince, Haiti, participated in a survey examining experience with and attitudes about MMC. Descriptive analyses investigated respondents’ views on MMC.

Results: Seventy one percent of respondents were females (n=44). Respondents included nurses working in hospitals (35%), 34% physicians and the rest were dentists, lab technicians, and psychologists. Ninety six percent of respondents believed MMC improved hygiene; 84% believed MMC was beneficial for STI prevention; 61.8% believed that MMC reduced HIV infection risk; and 43% believed that MMC reduced penile cancer risk. Over 80% of respondents were willing to undergo further training to practice performing or assisting MMC. Furthermore, 84% of respondents believed their patients would accept MMC for prevention of HIV/STIs and 74% believed that the best age for MMC was during infancy. Only eight respondents (13%) reported that they had received previous training in performing MMC, nine had performed MMC in the past, and an additional 11 respondents had ever assisted in MMC procedures.

Conclusions: The results of this study suggest that MMC has high acceptability among medical providers in Port-au-Prince, Haiti.  The majority were knowledgeable about the advantages of MMC. However, as in other resource limited settings, the lack of a trained workforce is one of the barriers in implementing MMC on a large scale. Although medical providers believed that their patients might be willing to undergo MMC, increasing the availability of such services remains a crucial first step.