“Promote the Uptake of Male Circumcision" for HIV Prevention: A Concept Analysis

Abstract

Over the past decade, efforts have been made to promote the uptake of male circumcision (MC) in 14 selected high HIV epidemic countries, following reports that MC reduces the risk of female-to-male HIV transmission by about 60 per cent. Despite these efforts, the uptake of MC remains low, partly due to poor and/or subjective understanding of the concept “promote the uptake of MC” in the context of HIV prevention. This study aimed at clarifying the conceptual meaning of “promote the uptake of MC” for HIV prevention in high HIV and low MC prevalent settings. Walker and Avant’s eight-step method of concept analysis was used. An integrative review of literature was conducted. An open online search was conducted using Google and Google Scholar, targeting all relevant literature, grey and scientific. Specific databases were also explored, which included PubMed, Science Direct, SCORPUS, and CINAHL. Accessible relevant hard copy literature was also considered. Data were analysed qualitatively and thematically. Findings show that the concept “promote the uptake of MC” has connotations that extend to several contexts, which include culture and religion, biomedical sciences, education, construction, as well as health and medicine. Conceptually, in HIV prevention, it is a process that involves healthcare providers, uncircumcised men and their social environment. The integral components of the process are educative interactions, the provision of MC services and social support. It is recommended that healthcare providers carefully consider this conceptual understanding in their efforts to promote the uptake of MC for HIV prevention.