Impact of a comprehension assessment among adult and adolescent clients on scale up of male circumcision services in Zambia (PDF)
Poster presentation at the 6th International AIDS Society Conference, Rome, Italy, 17-20 July
Friedland,Barbara A.; Apicella,Louis; Sheehy,Meredith; Schenk,Katie D.; Munjile,Kelvin; Adams,Alfred; Hewett,Paul C.; Katzen,Lauren L.
Publication date: 2011
Poster presentation given by Population Council researcher, Lauren Katzen, at the 6th International AIDS Society Conference in Rome, Italy, 17-20 July 2011. As part of an evaluation of the informed consent process for male circumcision (MC) at selected clinics in Zambia, Council researchers and partners assessed clients' comprehension of key MC concepts to improve, standardize and streamline consent procedures as service delivery was expanded. 89 percent of clients passed the test (mean score = 8.9). Only 67% of clients responded that there are risks involved in MC surgery; more adults (71%) than adolescents (57%) answered correctly (p < 0.05). Logistic regression indicated 3 factors associated with passing (p < 0.05): 1) passing the literacy test (6 times more likely to pass true/false test); 2) completing secondary education or higher (5 times more likely to pass); and 3) counseling in most comfortable language (3 times more likely to pass). Clients also had a hard time understanding the terms "risk" when referring to the MC surgery and "partial protection". Many did not know if MC protects their female partners and that HIV risk is increased by having sex too soon post-surgery (6 weeks). Researchers suggest that MC programs should work to optimize client comprehension to ensure truly informed consent, while also helping to reduce the uptake of risk behaviors post-MC