Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia

Abstract

Background: Voluntary medical male circumcision (VMMC) is a strategy used to try to limit new human immunodeficiency virus (HIV) infections, as it has the potential to reduce HIV and/or AIDS transmission from women to men by up to 60%. However, in spite of efforts by the Ministry of Health and Social Services, only a few men in Namibia have been circumcised. The objective of this study was to explore and describe the facilitators of, and barriers to, medical male circumcision for HIV prevention in Kavango East, Namibia.

Methods: A qualitative, explorative, descriptive and contextual design was employed. The accessible population in this study comprised 18 health professionals who were selected for the study using a purposive sampling technique.

Results: Participants reported numerous barriers to VMMC in Namibia. Barriers to VMMC included ‘myths’ and misconceptions attached to VMMC, age limitations, fear of pain and stigma associated with HIV, small VMMC team and long distances from health facilities. Facilitators to VMMC included family support, having experienced genital sores and genital warts or phimosis and paraphimosis.

Conclusion: The study revealed that a number of barriers must be overcome before VMMC before the desired number of men take advantage of VMMC. Multiple factors act as constraints to VMMC, including fear, myths and misconceptions, small VMMC teams and the long distance between clients’ homes and VMMC services.

Contribution: The study’s findings can be used to develop targeted interventions and strategies that can be used by VMMC providers to address the identified barriers.