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Advances in Social Sciences Research Journal – Vol.7, No.7
Publication Date: July 25, 2020
DOI:10.14738/assrj.77.8659.
Emojong, O. (2020). Influence Of Interpersonal Communication Partner On Uptake Of Voluntary Medical Male Circumcision Among
Married Men In Kenya: An Evaluation Study Of Information Source Attributes. Advances in Social Sciences Research Journal, 7(7) 825-
842.
Influence Of Interpersonal Communication Partner On Uptake Of
Voluntary Medical Male Circumcision Among Married Men In Kenya:
An Evaluation Study Of Information Source Attributes
Omukule Emojong
Department of Communication,
Media Technology, Maseno University, Kenya
ABSTRACT
Background: Studies have shown that male circumcision offers partial
“vaccine” against heterosexually acquired HIV as a result WHO
recommended it as one of the strategies to fight the AIDS scourge.
Married and older men have registered low uptake of the “cut” in the
targeted communities in Kenya. Considerable evidence suggests that
communication inequality and choice of interpersonal information
source are determinants in adoption of healthy behaviours such as
adoption of male circumcision. This study aimed to examine how
interpersonal communication source attributes (trust, similarity and
expertise) may influence uptake of male circumcision among married
men in Busia County, Kenya. Methods: Voluntary medical male
circumcision (VMMC) programme targets males aged up to 49 years.
This study targeted married men aged between 20 and 49 years.
Measures included socio-demographic characteristics, sources of VMMC
information, perception on interpersonal source attributes of trust,
expertise, and similarity between source and recipient. Sources
regarded as trusted and expert were also measured including similarity
dimensions of ethnicity, gender, age and marital status. A total of 377
participants completed the self-administered questionnaires, giving a
response rate of 100%. Descriptive statistics tables such as those
showing frequencies, mean and standard deviation of constructs were
used. Due to the nature of the data collected, the Pearson Product- Moment Correlation Coefficient was computed to measure the
relationship between socio-demographic characteristics and
interpersonal communication source attribute. Results: The Pearson
Correlation computed revealed there existed a significant positive
correlation between age and source trustworthiness and negative
correlation with expertise. Marriage duration had a significant positive
correlation with trustworthiness of source attribute. Trusted source
was a friend. A health care provider was regarded as an expert source
while similarity between source and recipient dimensions of age and
ethnicity were given more weight. Health worker was the most popular
source of VMMC information. Conclusion: This study has revealed
fundamental insights and provided evidence that the quality of the
message carrier and demographic characteristics are critical factors to
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URL: http://dx.doi.org/10.14738/assrj.77.8659 826
Emojong, O. (2020). Influence Of Interpersonal Communication Partner On Uptake Of Voluntary Medical Male Circumcision Among Married Men In Kenya:
An Evaluation Study Of Information Source Attributes. Advances in Social Sciences Research Journal, 7(7) 825-842.
consider in implementing VMMC programme especially targeting
married and older men who register low uptake. VMMC programmes
using interpersonal channels must put more premium on the choice of
the messenger as trust and expertise of source including similarity
between communication partners is vital in the success of such
communication interventions involving adoption of a sensitive cultural
and sexual issue especially targeting married men.
Keywords: Interpersonal communication, health communication, health
information source, voluntary medical male circumcision, HIV/AIDS, Kenya.
INTRODUCTION
HIV/AIDS is a global epidemic, unprecedented in its scope and impact, has mobilized outrageous
outpouring action worldwide. It is now almost four decades since the first case of AIDS were
diagnosed. According to a joint report by AVAC, National Empowerment Network of People Living
with HIV/AIDS in Kenya, Sonke Gender Justice Network and Uganda Network of AIDS Service
Organizations [1] there has been a growing array of proven strategies and promising research on
HIV prevention. However, some of these interventions have not realized their goals since HIV
prevalence rates have remained high. Voluntary medical male circumcision (VMMC) is one such
adopted interventions.
Data from a range of observational epidemiological studies, conducted since the mid-1980s
indicated that circumcised men have a lower prevalence of HIV infection than uncircumcised men.
Research show that male circumcision has an HIV prevention impact [2]. Three randomized
controlled trials have suggested that male circumcision reduces HIV acquisition from female
partners by approximately 60 percent [3-5]. Informed by these findings, World Health Organization
(WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended medical
male circumcision as part of HIV prevention interventions. WHO and UNAIDS identified and
prioritized fourteen countries in southern and Eastern Africa with low male circumcision and high
HIV prevalence rates for scale-up of VMMC [6].
Male circumcision is one of those measures that can be taken to reduce the vulnerability of not only
married men and also women to HIV infection. This is because as many men are circumcised,
women are less likely to encounter sexual partners who are living with HIV [7, 8]. Hankins et al. [9]
add their voice to this argument by stating that “early on, most HIV infections averted occurred
among men, but the proportion among women would steadily increase over time until almost half
of all HIV infections averted in year 2025 are those that would have occurred among women.”
Mathematical modeling from Tanzania found out that in the absence of male circumcision, the
annual number of new HIV infections was expected to rise from 84,000 in 2010 to 86,000 in 2025.
However, with VMMC, a commendable decline of 64,000 HIV infections will be expected [10].
Despite the overwhelming scientific evidence and formal recommendation by WHO/UNAIDS,
efforts to scale up medical male circumcision in the targeted priority countries in sub Saharan Africa
have yielded mixed results [9] which can partially be attributed to inadequate supply of health care
resources required for VMMC [11]. In view of this noted shortage, new male circumcision devices
such as the Shang Ring and PrePex which need minimal or no surgery have been invented. With
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Advances in Social Sciences Research Journal (ASSRJ) Vol.7, Issue 7, July-2020
these inventions however, the demand for circumcision by sexually active men in the priority
countries has still been low, and it appears the devices alone will unlikely solve all demand creation
challenges. A joint report of AVAC, National Empowerment Network of People Living with HIV/AIDS
in Kenya, Sonke Gender Justice Network and Uganda Network of AIDS Service Organization on
VMMC [1] recommends the need to investigate reasons why men do or do not access VMMC
services, optimal messages and communication channels, and key message carriers to motivate
VMMC services. Generally speaking, in order to optimize the potential impact of a given message,
the selection of a communication source is crucial and a complex process involving knowledge of
the audience and of the health behavior change message. Credible sources can increase the
likelihood that a “weak” message will be accepted [12]. This study therefore evaluates the influence
of interpersonal communication partner as male circumcision message carrier in the uptake of
VMMC targeting married men.
The addition of male circumcision to the HIV prevention ‘toolbox’ is an important and relatively
recent advance however, it is the oldest known surgical procedure and practiced across the world
for various reasons. According to Keller (1956) as cited by Doyle [13] circumcision started around
the 4th Millennium BC among the Sumerians and Semites who are the descendants of the Hebrews.
For a very long time ritual circumcision has been practiced by the Australian Aborigines, South Sea
Islanders, Sumatrans, Incas, Aztecs, Mayans and ancient Egyptians.
Variation in male circumcision prevalence in Africa is attributed to differences in ethnic groups,
such as Nilotic or Sudanic speakers who are traditionally non-circumcising. Also, within the Bantu
speakers there are ethnic groups who abandoned male circumcision centuries ago for various
reasons. For example, in Botswana, southern Zimbabwe, Malawi and parts of South Africa
circumcision was stopped by the European missionaries and colonial administrators. Swazi King
Mswati II abandoned male circumcision arguing then that it incapacitated men during war times as
noted by Marck (1997) as cited by WHO [14].
Kenya is one of the countries in sub-Saharan Africa prioritized by WHO and UNAIDS to implement
VMMC. According to the Kenya Demographic Health Survey of 2008-09 [15], more than 80 percent
of men were circumcised, with this figure unevenly distributed culturally and geographically across
the country. Teso South and North sub counties in Busia County in western Kenya are
predominantly occupied by the Iteso ethnic group that does not practice traditional male
circumcision. The Kenyan government through the ministry of health in partnership with
nongovernmental organizations have rolled out a national strategy that is aimed at circumcising 80
percent of uncircumcised HIV-negative men between ages 15 and 49 (approximately 860,000 men
across the entire country) between 2008 and 2013 as noted in the Progress Report on Kenya’s
VMMC Programme of 2011 [16].
According to the Kenya AIDS Indicator Survey (KAIS) of 2007, 85 percent of men reported that they
were circumcised. But male circumcision rates vary by former provinces, ranging from 48 percent
in Nyanza to 97 percent in Coast and North Eastern where Islam is the dominant religion that
practices male circumcision [17]. However, it is important to note that in the years 2016 and 2017
the VMMC program surpassed its target by 110% and 126% respectively [18]. Like in most ethnic
groups, male circumcision is an important part in the transition to manhood. It is believed to be
associated with masculinity, social cohesion and social desirability, self-identity and spirituality