Soccer-based promotion of voluntary medical male circumcision: A mixed-methods feasibility study with secondary students in Uganda
Identifieur interne : 000234 ( Main/Exploration ); précédent : 000233; suivant : 000235Soccer-based promotion of voluntary medical male circumcision: A mixed-methods feasibility study with secondary students in Uganda
Auteurs : George Miiro [Ouganda] ; Jeff Decelles [Afrique du Sud, États-Unis] ; Rwamahe Rutakumwa [Ouganda] ; Jessica Nakiyingi-Miiro [Ouganda] ; Philip Muzira [Afrique du Sud] ; Wilber Ssembajjwe [Ouganda] ; Saidat Musoke [Ouganda] ; Lorna J. Gibson [Royaume-Uni] ; Rebecca B. Hershow [États-Unis] ; Suzanna Francis [Royaume-Uni] ; Belen Torondel [Royaume-Uni] ; David A. Ross ; Helen A. Weiss [Royaume-Uni]Source :
- PLoS ONE [ 1932-6203 ] ; 2017.
Descripteurs français
- KwdFr :
- Adolescent, Circoncision masculine, Consommation d'alcool (épidémiologie), Football, Humains, Infections à VIH (), Infections à VIH (virologie), Infections à VIH (épidémiologie), Jeune adulte, Mâle, Ouganda, Parents, Religion, VIH (Virus de l'Immunodéficience Humaine) (pathogénicité), Établissements scolaires.
- MESH :
- pathogénicité : VIH (Virus de l'Immunodéficience Humaine).
- virologie : Infections à VIH.
- épidémiologie : Consommation d'alcool, Infections à VIH.
- Adolescent, Circoncision masculine, Football, Humains, Infections à VIH, Jeune adulte, Mâle, Ouganda, Parents, Religion, Établissements scolaires.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Alcohol Drinking, HIV Infections.
- pathogenicity : HIV.
- prevention & control : HIV Infections.
- virology : HIV Infections.
- Adolescent, Circumcision, Male, Humans, Male, Parents, Religion, Schools, Soccer, Uganda, Young Adult.
Abstract
The Ugandan government is committed to scaling-up proven HIV prevention strategies including safe male circumcision, and innovative strategies are needed to increase circumcision uptake. The aim of this study was to assess the acceptability and feasibility of implementing a soccer-based intervention (“Make The Cut”) among schoolboys in a peri-urban district of Uganda. The intervention was led by trained, recently circumcised “coaches” who facilitated a 60-minute session delivered in schools, including an interactive penalty shoot-out game using metaphors for HIV prevention, sharing of the coaches’ circumcision story, group discussion and ongoing engagement from the coach to facilitate linkage to male circumcision. The study took place in four secondary schools in Entebbe sub-district, Uganda. Acceptability of safe male circumcision was assessed through a cross-sectional quantitative survey. The feasibility of implementing the intervention was assessed by piloting the intervention in one school, modifying it, and implementing the modified version in a second school. Perceptions of the intervention were assessed with in-depth interviews with participants. Of the 210 boys in the cross-sectional survey, 59% reported being circumcised. Findings showed high levels of knowledge and generally favourable perceptions of circumcision. The initial implementation of Make The Cut resulted in 6/58 uncircumcised boys (10.3%) becoming circumcised. Changes made included increasing engagement with parents and improved liaison with schools regarding the timing of the intervention. Following this, uptake improved to 18/69 (26.1%) in the second school. In-depth interviews highlighted the important role of family and peer support and the coach in facilitating the decision to circumcise. This study showed that the modified Make The Cut intervention may be effective to increase uptake of safe male circumcision in this population. However, the intervention is time-intensive, and further work is needed to assess the cost-effectiveness of the intervention conducted at scale.
Url:
DOI: 10.1371/journal.pone.0185929
PubMed: 29016651
PubMed Central: 5633183
Affiliations:
- Afrique du Sud, Ouganda, Royaume-Uni, États-Unis
- Angleterre, Caroline du Nord, Grand Londres
- Londres
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Le document en format XML
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id="aff004"><addr-line>Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe</wicri:regionArea><wicri:noRegion>Entebbe</wicri:noRegion></affiliation></author><author><name sortKey="Nakiyingi Miiro, Jessica" sort="Nakiyingi Miiro, Jessica" uniqKey="Nakiyingi Miiro J" first="Jessica" last="Nakiyingi-Miiro">Jessica Nakiyingi-Miiro</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe</wicri:regionArea><wicri:noRegion>Entebbe</wicri:noRegion></affiliation></author><author><name sortKey="Muzira, Philip" sort="Muzira, Philip" uniqKey="Muzira P" first="Philip" last="Muzira">Philip Muzira</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Grassroot Soccer, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Grassroot Soccer, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Ssembajjwe, Wilber" sort="Ssembajjwe, Wilber" uniqKey="Ssembajjwe W" first="Wilber" last="Ssembajjwe">Wilber Ssembajjwe</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Uganda Virus Research Institute, Entebbe, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Uganda Virus Research Institute, Entebbe</wicri:regionArea><wicri:noRegion>Entebbe</wicri:noRegion></affiliation></author><author><name sortKey="Musoke, Saidat" sort="Musoke, Saidat" uniqKey="Musoke S" first="Saidat" last="Musoke">Saidat Musoke</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Uganda Virus Research Institute, Entebbe, Uganda</addr-line></nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Uganda Virus Research Institute, Entebbe</wicri:regionArea><wicri:noRegion>Entebbe</wicri:noRegion></affiliation></author><author><name sortKey="Gibson, Lorna J" sort="Gibson, Lorna J" uniqKey="Gibson L" first="Lorna J." last="Gibson">Lorna J. Gibson</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hershow, Rebecca B" sort="Hershow, Rebecca B" uniqKey="Hershow R" first="Rebecca B." last="Hershow">Rebecca B. Hershow</name><affiliation wicri:level="2"><nlm:aff id="aff003"><addr-line>University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Francis, Suzanna" sort="Francis, Suzanna" uniqKey="Francis S" first="Suzanna" last="Francis">Suzanna Francis</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Torondel, Belen" sort="Torondel, Belen" uniqKey="Torondel B" first="Belen" last="Torondel">Belen Torondel</name><affiliation wicri:level="3"><nlm:aff id="aff006"><addr-line>Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Disease Control, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Ross, David A" sort="Ross, David A" uniqKey="Ross D" first="David A." last="Ross">David A. Ross</name><affiliation><nlm:aff id="aff007"><addr-line>Department of Maternal, Newborn, Child and Adolescent Health, World Health Organisation, Geneva, Swizterland</addr-line></nlm:aff><wicri:noCountry code="subfield">Swizterland</wicri:noCountry></affiliation></author><author><name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A." last="Weiss">Helen A. Weiss</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Alcohol Drinking (epidemiology)</term><term>Circumcision, Male</term><term>HIV (pathogenicity)</term><term>HIV Infections (epidemiology)</term><term>HIV Infections (prevention & control)</term><term>HIV Infections (virology)</term><term>Humans</term><term>Male</term><term>Parents</term><term>Religion</term><term>Schools</term><term>Soccer</term><term>Uganda</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Circoncision masculine</term><term>Consommation d'alcool (épidémiologie)</term><term>Football</term><term>Humains</term><term>Infections à VIH ()</term><term>Infections à VIH (virologie)</term><term>Infections à VIH (épidémiologie)</term><term>Jeune adulte</term><term>Mâle</term><term>Ouganda</term><term>Parents</term><term>Religion</term><term>VIH (Virus de l'Immunodéficience Humaine) (pathogénicité)</term><term>Établissements scolaires</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Alcohol Drinking</term><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>HIV</term></keywords><keywords scheme="MESH" qualifier="pathogénicité" xml:lang="fr"><term>VIH (Virus de l'Immunodéficience Humaine)</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Consommation d'alcool</term><term>Infections à VIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Circumcision, Male</term><term>Humans</term><term>Male</term><term>Parents</term><term>Religion</term><term>Schools</term><term>Soccer</term><term>Uganda</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Circoncision masculine</term><term>Football</term><term>Humains</term><term>Infections à VIH</term><term>Jeune adulte</term><term>Mâle</term><term>Ouganda</term><term>Parents</term><term>Religion</term><term>Établissements scolaires</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The Ugandan government is committed to scaling-up proven HIV prevention strategies including safe male circumcision, and innovative strategies are needed to increase circumcision uptake. The aim of this study was to assess the acceptability and feasibility of implementing a soccer-based intervention (“Make The Cut”) among schoolboys in a peri-urban district of Uganda. The intervention was led by trained, recently circumcised “coaches” who facilitated a 60-minute session delivered in schools, including an interactive penalty shoot-out game using metaphors for HIV prevention, sharing of the coaches’ circumcision story, group discussion and ongoing engagement from the coach to facilitate linkage to male circumcision. The study took place in four secondary schools in Entebbe sub-district, Uganda. Acceptability of safe male circumcision was assessed through a cross-sectional quantitative survey. The feasibility of implementing the intervention was assessed by piloting the intervention in one school, modifying it, and implementing the modified version in a second school. Perceptions of the intervention were assessed with in-depth interviews with participants. Of the 210 boys in the cross-sectional survey, 59% reported being circumcised. Findings showed high levels of knowledge and generally favourable perceptions of circumcision. The initial implementation of Make The Cut resulted in 6/58 uncircumcised boys (10.3%) becoming circumcised. Changes made included increasing engagement with parents and improved liaison with schools regarding the timing of the intervention. Following this, uptake improved to 18/69 (26.1%) in the second school. In-depth interviews highlighted the important role of family and peer support and the coach in facilitating the decision to circumcise. This study showed that the modified Make The Cut intervention may be effective to increase uptake of safe male circumcision in this population. 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