(P26) Medical Male Circumcision (MMC) and HIV Testing Practices Among Men: Evidence from Zambia Demographics & Health Survey

Background. Medical male circumcision (MMC) was commonly adopted by many sub-Saharan countries as a preventative strategy against HIV following several RCT studies that demonstrated its efficacy. The protective effects of the intervention against HIV risk infections among heterosexual sexually active males is well supported by empirical evidence. Many countries with low rates of male circumcision like Zambia continue to scale up voluntary MMC programs. However, little is known about the association of medical male circumcision and HIV testing in Zambia. The study addresses the knowledge gap by examining factors associated with HIV testing and medical male circumcision in Zambia.

Methods: Data for the study were derived from the 2018 Zambia Demographic and Health Survey (ZDHS), a cross-sectional survey of males between 15 to 59 years (n=12,123). Bivariate analyses assessed the relationship between MMC and HIV testing (dependent variable; yes/no). Multivariate logistic regression analyses examined the association of all categorical independent variables (province, resident type, age, marital status, employment, religion, income, and HIV testing and MMC) and dependent variables (HIV testing and MCC alternatively).

Results: Men who were living in the Copperbelt and Western provinces were more likely to be circumcised compared to those from the Eastern, Luapula, Lusaka, Northern, and Northwestern provinces. Living in rural areas was associated with lower odds of being circumcised and HIV testing. Men in age categories 35 to 44 and 45 to 59 were less likely to be circumcised. Men who did not test for HIV were less likely to undergo MMC, but those who did MMC had higher odds of being tested for HIV. Being married or unmarried was associated with higher likelihood of being tested for HIV than other groups.

Conclusions: The findings underscore the need for education campaigns on the health benefits of MMC and HIV testing to be targeted towards men in rural areas and those from low income brackets. This may increase the acceptance of MMC and HIV testing among populations that are still lagging behind as a result of resource shortage and religious and cultural beliefs.