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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya</title><author><name sortKey="Thirumurthy, Harsha" sort="Thirumurthy, Harsha" uniqKey="Thirumurthy H" first="Harsha" last="Thirumurthy">Harsha Thirumurthy</name></author><author><name sortKey="Masters, Samuel H" sort="Masters, Samuel H" uniqKey="Masters S" first="Samuel H." last="Masters">Samuel H. Masters</name></author><author><name sortKey="Rao, Samwel" sort="Rao, Samwel" uniqKey="Rao S" first="Samwel" last="Rao">Samwel Rao</name></author><author><name sortKey="Bronson, Megan A" sort="Bronson, Megan A" uniqKey="Bronson M" first="Megan A." last="Bronson">Megan A. Bronson</name></author><author><name sortKey="Lanham, Michele" sort="Lanham, Michele" uniqKey="Lanham M" first="Michele" last="Lanham">Michele Lanham</name></author><author><name sortKey="Omanga, Eunice" sort="Omanga, Eunice" uniqKey="Omanga E" first="Eunice" last="Omanga">Eunice Omanga</name></author><author><name sortKey="Evens, Emily" sort="Evens, Emily" uniqKey="Evens E" first="Emily" last="Evens">Emily Evens</name></author><author><name sortKey="Agot, Kawango" sort="Agot, Kawango" uniqKey="Agot K" first="Kawango" last="Agot">Kawango Agot</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25042290</idno><idno type="pmc">4268484</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268484</idno><idno type="RBID">PMC:4268484</idno><idno type="doi">10.1001/jama.2014.9087</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001B56</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001B56</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya</title><author><name sortKey="Thirumurthy, Harsha" sort="Thirumurthy, Harsha" uniqKey="Thirumurthy H" first="Harsha" last="Thirumurthy">Harsha Thirumurthy</name></author><author><name sortKey="Masters, Samuel H" sort="Masters, Samuel H" uniqKey="Masters S" first="Samuel H." last="Masters">Samuel H. Masters</name></author><author><name sortKey="Rao, Samwel" sort="Rao, Samwel" uniqKey="Rao S" first="Samwel" last="Rao">Samwel Rao</name></author><author><name sortKey="Bronson, Megan A" sort="Bronson, Megan A" uniqKey="Bronson M" first="Megan A." last="Bronson">Megan A. Bronson</name></author><author><name sortKey="Lanham, Michele" sort="Lanham, Michele" uniqKey="Lanham M" first="Michele" last="Lanham">Michele Lanham</name></author><author><name sortKey="Omanga, Eunice" sort="Omanga, Eunice" uniqKey="Omanga E" first="Eunice" last="Omanga">Eunice Omanga</name></author><author><name sortKey="Evens, Emily" sort="Evens, Emily" uniqKey="Evens E" first="Emily" last="Evens">Emily Evens</name></author><author><name sortKey="Agot, Kawango" sort="Agot, Kawango" uniqKey="Agot K" first="Kawango" last="Agot">Kawango Agot</name></author></analytic><series><title level="j">JAMA</title><idno type="ISSN">0098-7484</idno><idno type="eISSN">1538-3598</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>IMPORTANCE</title><p id="P1">Novel strategies are needed to increase the uptake of voluntary medical male circumcision (VMMC) in sub-Saharan Africa and enhance the effectiveness of male circumcision as an HIV prevention strategy.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P2">To determine whether small economic incentives could increase circumcision prevalence by addressing reported economic barriers to VMMC and behavioral factors such as present-biased decision making.</p></sec><sec id="S3"><title>DESIGN, SETTING, AND PARTICIPANTS</title><p id="P3">Randomized clinical trial conducted between June 22, 2013, and February 4, 2014, among 1504 uncircumcised men aged 25 to 49 years in Nyanza region, Kenya. VMMC services were provided free of charge and participants were randomized to 1 of 3 intervention groups or a control group.</p></sec><sec id="S4"><title>INTERVENTIONS</title><p id="P4">Participants in the 3 intervention groups received varying amounts of compensation conditional on undergoing circumcision at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of food vouchers worth 200 Kenya shillings (≈US $2.50), 700 Kenya shillings (≈US $8.75), or 1200 Kenya shillings (≈US $15.00), which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation.</p></sec><sec id="S5"><title>MAIN OUTCOMES AND MEASURES</title><p id="P5">VMMC uptake within 2 months.</p></sec><sec id="S6"><title>RESULTS</title><p id="P6">Analysis of data for 1502 participants with complete data showed that VMMC uptake within 2 months was higher in the US $8.75 group (6.6%; 95% CI, 4.3%–9.5% [25 of 381]) and the US $15.00 group (9.0%; 95% CI, 6.3%–12.4% [34 of 377]) than in the US $2.50 group (1.9%; 95% CI, 0.8%–3.8% [7 of 374]) and the control group (1.6%; 95% CI, 0.6%–3.5% [6 of 370]). In logistic regression analysis, the US $8.75 group had significantly higher VMMC uptake than the control group (adjusted odds ratio [AOR] 4.3; 95% CI, 1.7–10.7), as did the US $15.00 group (AOR 6.2; 95% CI, 2.6–15.0). Effect sizes for the US $8.75 and US $15.00 groups did not differ significantly (<italic>P</italic> = .20).</p></sec><sec id="S7"><title>CONCLUSIONS AND RELEVANCE</title><p id="P7">Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately US $8.75 or US $15.00, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months. The effects of more intense promotion or longer implementation require further investigation.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7501160</journal-id><journal-id journal-id-type="pubmed-jr-id">5346</journal-id><journal-id journal-id-type="nlm-ta">JAMA</journal-id><journal-id journal-id-type="iso-abbrev">JAMA</journal-id><journal-title-group><journal-title>JAMA</journal-title></journal-title-group><issn pub-type="ppub">0098-7484</issn><issn pub-type="epub">1538-3598</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25042290</article-id><article-id pub-id-type="pmc">4268484</article-id><article-id pub-id-type="doi">10.1001/jama.2014.9087</article-id><article-id pub-id-type="manuscript">NIHMS647701</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya</article-title><subtitle>A Randomized Clinical Trial</subtitle></title-group><contrib-group><contrib contrib-type="author"><name><surname>Thirumurthy</surname><given-names>Harsha</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Masters</surname><given-names>Samuel H.</given-names></name><degrees>MPH</degrees></contrib><contrib contrib-type="author"><name><surname>Rao</surname><given-names>Samwel</given-names></name><degrees>MPH</degrees></contrib><contrib contrib-type="author"><name><surname>Bronson</surname><given-names>Megan A.</given-names></name><degrees>MPH</degrees></contrib><contrib contrib-type="author"><name><surname>Lanham</surname><given-names>Michele</given-names></name><degrees>MPH</degrees></contrib><contrib contrib-type="author"><name><surname>Omanga</surname><given-names>Eunice</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Evens</surname><given-names>Emily</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Agot</surname><given-names>Kawango</given-names></name><degrees>PhD</degrees></contrib><aff id="A1">Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (Thirumurthy, Masters); Carolina Population Center, University of North Carolina at Chapel Hill (Thirumurthy, Bronson); Impact Research and Development Organization, Kisumu, Kenya (Rao, Omanga, Agot); FHI 360, Durham, North Carolina (Lanham, Evens)</aff></contrib-group><author-notes><corresp id="cor1"><bold>Corresponding Author:</bold> Harsha Thirumurthy, PhD, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Campus Box 7411, Chapel Hill, NC 27599-7411, <email>harsha@unc.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>10</day><month>12</month><year>2014</year></pub-date><pub-date pub-type="ppub"><day>20</day><month>8</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>17</day><month>12</month><year>2014</year></pub-date><volume>312</volume><issue>7</issue><fpage>703</fpage><lpage>711</lpage><pmc-comment>elocation-id from pubmed: 10.1001/jama.2014.9087</pmc-comment>
<permissions><copyright-statement>Copyright 2014 American Medical Association. All rights reserved.</copyright-statement><copyright-year>2014</copyright-year></permissions><abstract><sec id="S1"><title>IMPORTANCE</title><p id="P1">Novel strategies are needed to increase the uptake of voluntary medical male circumcision (VMMC) in sub-Saharan Africa and enhance the effectiveness of male circumcision as an HIV prevention strategy.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P2">To determine whether small economic incentives could increase circumcision prevalence by addressing reported economic barriers to VMMC and behavioral factors such as present-biased decision making.</p></sec><sec id="S3"><title>DESIGN, SETTING, AND PARTICIPANTS</title><p id="P3">Randomized clinical trial conducted between June 22, 2013, and February 4, 2014, among 1504 uncircumcised men aged 25 to 49 years in Nyanza region, Kenya. VMMC services were provided free of charge and participants were randomized to 1 of 3 intervention groups or a control group.</p></sec><sec id="S4"><title>INTERVENTIONS</title><p id="P4">Participants in the 3 intervention groups received varying amounts of compensation conditional on undergoing circumcision at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of food vouchers worth 200 Kenya shillings (≈US $2.50), 700 Kenya shillings (≈US $8.75), or 1200 Kenya shillings (≈US $15.00), which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation.</p></sec><sec id="S5"><title>MAIN OUTCOMES AND MEASURES</title><p id="P5">VMMC uptake within 2 months.</p></sec><sec id="S6"><title>RESULTS</title><p id="P6">Analysis of data for 1502 participants with complete data showed that VMMC uptake within 2 months was higher in the US $8.75 group (6.6%; 95% CI, 4.3%–9.5% [25 of 381]) and the US $15.00 group (9.0%; 95% CI, 6.3%–12.4% [34 of 377]) than in the US $2.50 group (1.9%; 95% CI, 0.8%–3.8% [7 of 374]) and the control group (1.6%; 95% CI, 0.6%–3.5% [6 of 370]). In logistic regression analysis, the US $8.75 group had significantly higher VMMC uptake than the control group (adjusted odds ratio [AOR] 4.3; 95% CI, 1.7–10.7), as did the US $15.00 group (AOR 6.2; 95% CI, 2.6–15.0). Effect sizes for the US $8.75 and US $15.00 groups did not differ significantly (<italic>P</italic> = .20).</p></sec><sec id="S7"><title>CONCLUSIONS AND RELEVANCE</title><p id="P7">Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately US $8.75 or US $15.00, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months. The effects of more intense promotion or longer implementation require further investigation.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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