Exploring HIV risk compensation among men with medical male circumcision uptake and oral pre-exposure prophylaxis use: a comparative study in Umlazi and Vulindlela in KwaZulu-Natal.

Abstract

There were approximately 38.0 million people globally, living with HIV at the end of 2019 and Sub-Saharan Africa accounts for a third of those living with HIV. New biomedical HIV prevention methods such as mother-to-child transmission (PMTCT), antiretroviral treatment (ART) and voluntary medical male circumcision (VMMC) have shown great promise. Oral PrEP has the potential to greatly aid in the reduction of HIV infection rates among men. The study uses the concepts of the Health Belief Model (HBM), Social Ecology Model for Communication and Health Behaviour (SEMCHB), and the Risk Compensation Theory (RCT) to understand factors that influence the decision-making process of men when choosing biomedical HIV prevention options. These theories also enable an understanding of how individuals perceive risk, the benefits of safe behaviour, and how this is realized in their actions. In this qualitative study, four focus group discussions were conducted with African males ages 18 – 39 in Umlazi and Vulindlela, KwaZulu-Natal. Data was analysed using thematic analysis, applying the constructs of the HBM, SEMCHB and RCT to develop themes and sub-themes. Key findings revealed that perception of risk and perceived susceptibility were low among the men. However, perceived severity was high. The researcher also observed a lack of knowledge of HIV acquisition, and lack of proper knowledge of biomedical HIV prevention methods, VMMC and PrEP.