Exploring a possible communication strategy to promote voluntary medical male circumcision for HIV prevention among males at the University of KwaZulu-Natal, Howard College.

Abstract

HIV/AIDS remains a global health concern with about 38 million people living with HIV globally in 2019, this consisted of 36,2 million adults and 1,8 million children. It was further estimated that there would be about 690 000 AIDS-related deaths in 2019. Following the success of three randomised trials to test the medical effectiveness of Voluntary Medical Male Circumcision (VMMC), undertaken in South Africa, Kenya and Uganda, it was found that VMMC reduces the chances of males contracting HIV by 50% to 60%. This means that there is a link between poor VMMC uptake and HIV prevalence. As a result, WHO declared it as a strategy to be included as part of combination prevention strategies. Furthermore, WHO declared that “HIV remains the single largest cause of deaths among adolescent boys and men of reproductive age in eastern and southern Africa”. The targeted adolescent boys and men are the focus because they are challenged by sociocultural factors ranging from toxic masculinity to substance abuse that may lead them to potentially infecting their partners with HIV. It is for this reason that VMMC is the key focus in this study. This study was conducted at the University of KwaZulu-Natal, Howard College Campus. The UKZN students have been identified as in high risk of HIV infection with a notable high number of students living with HIV. The study was conducted within the university residences reserved for students. This study had three objectives: (1) to investigate the communication strategies adopted at UKZN to promote VMMC (2) to assess the perceptions of UKZN students on VMMC communication strategies that have been adopted at UKZN (3) to identify the cultural factors that influence communication strategies adopted to advance VMMC at UKZN. This study is framed by the culture-centered approach (CCA) in understanding students’ experiences when they engage with the VMMC communication strategies that are aimed at them. The CCA is founded on the principles of listening to the voices and creating spaces for dialogue and culture to inform health strategies. However, it can still be used as a tool to understand communication strategies, as done in this study. The data was collected through 8 individual semi-structured interviews and supported with an extensive literature review that also informed the analysis. The key findings from this study suggested that the participants have been exposed to mass media communicating about HIV prevention strategies at Howard College Campus, however, there has been limited VMMC uptake. The students have demonstrated poor preference for mass media as they did not resonate with the platform. Instead, the findings suggested that the students prefer to be directly approached by health promoters on campus and at their student accommodations. This was because the students prefer to engage with the health promoters by asking them questions and negotiating the meanings of the promoted messages. Furthermore, it was found that students would prefer that health promoters are popular individuals holding respectable statuses around campus as that would motivate the students to pay attention to them. This recommendation is consistent with previous studies done at UKZN where students preferred role-modelling as an effective strategy for health promotion. Lastly, the minority of the respondents suggested the use of social media platforms by UKZN to disseminate VMMC messages. The study found that participating in the communication process with VMMC promotion was important for UKZN students. Therefore, the communication strategy to advance VMMC communication in the future targets of HIV prevention should be culturally sensitive, context-specific and engage with the students through a two-way dialogue to avoid their marginalisation. Another finding was that some students would prefer to have VMMC messages available across social media platforms. In the context of entertainment education, the communication strategy does include the audience in the interventions as it seeks for social change. Furthermore, it has been applied in the promotion of VMMC to some extent, including on social media. Lastly, the study specifies that these results are limited to Black African students at Howard College Campus.