जर्नल ऑफ एड्स एंड क्लिनिकल रिसर्च

Perception, Concern and Acceptability of Neonatal Male Circumcision among Postpartum Mothers in Thailand

Abstract

Boonlure Pruenglampoo, Kriengkrai Srithanaviboonchai, Richard M. Grimes, Deanna E. Grimes, Jiraporn Suwanteerangkul, Jiraporn Khorana, Knittha Thaikla, Vipa Danthamrongkul, Suchada Paileeklee and Uraiwan Pattanasutnyavong

Introduction: Three randomized controlled trials involving over 11,000 men have demonstrated that male circumcision reduces female to male transmission of HIV. It is recommended by the World Health Organization as part of a HIV prevention program. Adult male circumcision is associated with significant complications while neonatal male circumcision (NMC) has few risks and may be a preferred prevention strategy. Internationally, NMC is seldom performed except as a religious ritual. So, introducing NMC in Thailand needs to determine its acceptability among mothers. Therefore a study was conducted among postpartum Thai mothers to determine their perceptions of, concerns about and acceptability of NMC.

Methods: A survey was conducted of 593 postpartum mothers from 16 hospitals in 4 provinces in Thailand. Data were analyzed using descriptive statistics, univariate analysis and binary logistic regression.

Results: 70 % of the participants reported that they knew or have heard about MC. Safety and pain were the major concerns of the mothers towards NMC. One-third would chose to have their infants circumcised after receiving the information about NMC, an additional third were undecided and 34.5% would not allow their sons to undergo NMC. Mothers (44.0 %) were the most influential person when it comes to the decision on NMC followed by fathers (37.9 %). In a multiple regression, having 9 years or greater of formal education (OR 1.64; 95% CI 1.01-2.66), having a circumcised husband (OR 2.88; 95% CI 1.11-7.50), and knowing of at least one circumcised child (OR 1.97; 95% CI 1.22-3.18) were independent predictors of acceptability to NMC among postpartum mothers.

Conclusions: The results suggest that NMC may be culturally neutral with evidence that even modest educational efforts can impact mothers’ decisions in favor of NMC. However, this study and a previous study suggest that both parents and health professionals need to be educated about the benefits of NMC.