June 21, 2012
Three randomized trials have shown male circumcision decreases female-to-male HIV incidence by 60 percent. The study authors note that this research in sub-Saharan Africa has centered on adolescents and adults. Modeling suggests the cost-effectiveness of infant male circumcision in high to moderate seroprevalent regions. The authors examined parental decision-making and differences in characteristics of parents in western Kenya accepting or declining IMC services.
In 2010, the case-control study was conducted at five government hospitals in Nyanza province. Mothers and fathers accepting IMC comprised the cases, while controls were parents who declined such services. A 41-question survey was administered.
The study enrolled 627 mothers and 493 fathers. Multivariable logistic regression modeling showed factors associated with mothers accepting IMC were: father circumcised (odds ratio=2.30, P<.001) and agreement with father about IMC decision (OR=4.38, P<.001). Among fathers, factors associated with accepting IMC were: being circumcised (OR=1.77; P=.016) and agreement with mother about IMC (OR=11.0, P<.001). In most instances (66 percent), fathers were the primary decision-makers. Just 3 percent of parents said they would prefer a future son to remain uncircumcised.
"Fathers are important in the IMC decision-making process," the authors concluded. "Fathers, as well as mothers, should be targeted for optimal scale-up of IMC services. Circumcision programs should offer services for males of all ages, as male circumcision at some age is highly acceptable to both men and women."