My study aims to provide insight into the decision-making factors that encourage young people to receive MMC, as well as their exposure to and effectiveness of public health communication initiatives in MMC, as their importance in the dissemination of MMC services is paramount. The guide identifies several 'key messages' to be conveyed in media promotion or MMC communication initiatives (JHHESA et al. 2008).
Chapter Two: Literature Review A Global Summary
As a potential result, "the protective effect of promoting condoms may be weakened at the population level and may even be offset by overall increases in risk behavior" (Cassell et al. The importance of the final limitation is reinforced by the results discussed earlier in the study conducted by Lagarde et al. Naledi et al. More than 80% of the South African population is dependent on the public sector for health care;.
The main focus of NCS 2009 was to examine the "impact of HIV communication programs in South Africa" in terms of HIV prevention and treatment (Johnson et al. 2010: 5).
Chapter Three: Theoretical Framework
The layered approach of the SEM is particularly distinct from the other somewhat controversial, individually oriented theories of health behavior change (McLeroy et al. 1988; Green, 1996). In combination with the social actors that exist in an individual's life, this level of SEM also recognizes the social norms and groups to which an individual actively subscribes. Synonymous with the intrapersonal factors of the SEM, the individual level of the SEMCHB refers to the knowledge, beliefs, self-efficacy, and general cognitive dispositions that an individual has toward a particular problem.
Like SEM's community level factors, SEMCHB's community level refers to an individual's physical as well as social community. The application of HBM will help interrogate and explain the interaction between communication strategies and the individual level variables highlighted in the SEMCHB. Accordingly, the HBM employed in my study allows me to examine some of the individual level factors delineated in my discussion of the SEMCHB.
The last of HBM's contributions to my participant question concerns the concept of self-efficacy. This would be because the individual's frame of knowledge would be at odds with the information disseminated. Through an initial discussion of the social ecological model of communication and health behavior, I clarified the complex interactions involved in health behavior change.
Chapter Four: Methodology
Convenience sampling refers to a sample that is “restricted to a portion of the population that is easily accessible” (Singh & Mangat, 1996: 7). The details and implications of the survey and semi-structured interview were explained in the individual's preferred language. At this point, individuals would indicate whether they were interested in participating in the study or not.
After the completion of the interview, the participant would proceed to collect their documentation at reception and wait to be escorted to the main building for group MMC counseling and booking. Thereby, this empowers the participant to guide and shape the data and maintains less interference on the part of the researcher. This ensured the least possible influence on the part of the researcher for the outcome of the participants' answers.
Through close reading of the data, emergent themes can be “categorized for analysis” (ibid.). In my presentation, the main importance of the well-being of the participants and the operation of the MMC clinic was emphasized. That is, they are not necessarily intended to be a reflection of the general public, but are more of a glimpse of the concerns that motivate my research question.
Chapter Five: Results and Discussion
It was noted that out of the eight participants who had referred to the Xhosa-Zulu circumcision controversy, seven were township residents. This participant chose MMC over traditional circumcision despite the cultural significance of the procedure within Xhosa culture. It was found that most men perceived themselves as being aware of the health benefits of MMC.
Four of the eight men who frequently used condoms were found to have a combination of HIV testing and condom use. The procedure requires complete removal of the foreskin, in the same way that MMC is performed. These are professionals [clinics and hospitals], they know what they are doing, they know what they are dealing with, they know that in the end it will be cured.
Unlike Freedom, participants who had been exposed to public health communication on the other hand, were divided into two groups, representing 56% and 44% of the sample. Interestingly, all participants who did not encounter health communication also stated that consistent condom use was imperative for a medically circumcised man. In Freedom's narrative, the presence of HIV is thought to be localized at the end of the penis, as opposed to circulating within bodily fluids as is the reality.
Mduduzi (20, Urban) was another to confirm Sipho's concerns: “The only thing that made it challenging for me was the fear of the pain”. 122 One of the clearest indications of the role of health communication in the process of developing self-efficacy was mentioned by Sbongiseni (24, Township).
Chapter Six: Conclusion and Recommendations
Nevertheless, the overall evidence showed that those exposed to MMC health communication provided more informed responses than those who were not. 126 Although individuals who were not indirectly exposed to MMC information and still missed any evidence of risk compensation, those who actually showed some degree of compensatory risk perception encountered limited exposure to health communication. MMC health communication stakeholders should therefore consider this a priority area, and future programs should further emphasize the mandatory six-week abstinence period following medical male circumcision.
Findings identify that 80% of the research participants were exposed to MMC health communication through mass media, which is a positive indicator for the availability of evidence-based information about MMC. Men who did not encounter MMC health communication were found to live exclusively in township areas. This suggests that village areas should be made priority locations for intensified MMC health communication initiatives.
Both findings urge MMC health communication stakeholders to consider strengthening evidence-based information programs targeting both partners and mothers. Worryingly, the majority of men who held this belief confirmed that they had been exposed to mediated health communication about MMC. The data collected show that the concept of male-to-female HIV transmission is either inadequately represented or incorrectly decoded in MMC health communication.
Journal of the National Cancer Institute, Vol. 2005) Randomized controlled intervention trial of male circumcision to reduce HIV infection risk: the ANRS 1265 trial. 2011) Impact of male circumcision on HIV risk compensation through the prevention of condom use in Botswana. Using thematic analysis in psychology. 2010) Condom avoidance and determinants of demand for male circumcision in Johannesburg, South Africa.
2012) Key Findings of the Third South African National HIV Communication Survey Male Circumcision and HIV Prevention in Eastern and Southern Africa: Communication Guide. 2003) Acceptability of male circumcision as a tool to prevent HIV infection in a highly infected community in South Africa. 2011) Rapid scale-up of medical male circumcision in non-medical settings in KwaZulu-Natal, South Africa.
2010) Desktop Review of South African Male Circumcision Research and Services. http://www.malecircumcision.org/programs/documents/Review_MC_research_services_SA. 2011) Ecological models revisited: Their uses and evolution in health promotion over two decades. 2010) Male Circumcision in the General Population of Kisumu, Kenya: Beliefs about Protection, Risk Behaviors, HIV and STIs. 2011) Progress in Scaling Up Male Circumcision for HIV Prevention in East and Southern Africa: Focus on Service Delivery.
Appendices Appendix 1: UKZN Ethical Clearance Form
If you do not choose to participate, this will not affect the care available to you at the Hospital. You can choose to stop your participation at any time. This will not affect the care and services available to you in the hospital. If you decide to participate in my study, you will be asked to participate in a short interview with me.
The information you provide will be kept private and not shown to anyone outside the research team. The interview will be recorded on a voice recorder, which will also be treated confidentially and retained by the University of KwaZulu-Natal. You can choose not to answer a specific question if you don't feel comfortable doing so, without penalty.
There will be no direct benefit to you from participating in the study, but your participation will help us learn more about how local men understand MMC. If you choose to participate in my study and would like to see the results of this interview, a completed report will be filed with the clinic upon completion of the study, which is expected to be in December 2012. None of what is audio recorded will be made available to anyone in the audience, it will only be used by the researcher to remember what was said here.
Certificate of Consent
Would you like to ask me any questions before you start the research? I witnessed the consent form being carefully read to the potential participant, and the person had the opportunity to ask questions. I witnessed the consent form being carefully read to the potential participant, and the person had the opportunity to ask questions.
I have carefully read the information sheet to the potential participant and to the best of my ability I have ensured that the participant understands that the following will be done:. What are your views on HIV and how do you deal with the issue of HIV in your sexual relationships. What other information do you wish you had before deciding to get circumcised?
Do you think you should abstain from sex after being circumcised? Based on your understanding of the issue and what you have been told, do you believe it is necessary for a man to wear a condom during sex with a woman after medical circumcision. Would you say it is safe for a man to have more than one sexual partner if he is medically circumcised?
GET CIRCUMCISED
KNOW THE FACTS
