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Background: Voluntary Medical Male Circumcision (VMMC) has been identified as a priority by the South African Government in the combination HIV prevention strategy. Demand creation remains a major challenge in achieving the goal of 4.2 million circumcisions by 2017. To maximize impact of demand creation activities, the most effective strategies to mobilize men for circumcision should be identified and prioritized.
Methods: From May-July, 2015, VMMC knowledge acquisition and mobilization data were routinely collected from men presenting to the PEPFAR VMMC program. For this analysis we examined only available data from one of five NGO''s in five provinces: KwaZulu Natal, Mpumalanga, Gauteng, and Free State. Descriptive statistical analysis was conducted using Microsoft Excel.
Results: Among 10,476 overall participants, 69.4% reported hearing about VMMC through NGOs, with 6,267 (59.8%) learning through community-based social mobilizers and an additional 1,008 (9.6%) through other NGO activities. Patients also reported knowledge acquisition of VMMC from a friend (13.6%) or family member (5.6%). Less than 2% reported hearing about VMMC either from TV or radio,. A subset of patients (n=8,252), were asked what motivated them to come in for VMMC on their procedure day. The majority reported externally motivating factors: encouragement by an NGO social mobiliser (47.2%), encouragement by a friend or family member (8.1%), or having the financial means for transport and missed work (6.4%). Fewer patients reported internal motivations: 12.6% reported either “I was ready today” or “I just decided to come,” and 25.7% reported various other factors.
Conclusions: Our results show that interpersonal communication, particularly through community-based social mobilizers, remains the predominant means by which men learn about and are prompted to seek VMMC and should be prioritized in program planning. Patient communication with family and friends also served as an important motivator, and additional exploration of how this support can be utilized to promote VMMC is needed. Despite ongoing national multimedia VMMC campaigns during this timeframe, these were rarely cited as the predominant motivating factor for men presenting to VMMC clinics. More investigation is warranted to examine the role of media in VMMC patient decision-making, as an additive effect of internal and external factors is likely.