Haiti has more than 120,000 people living with HIV, the most in the Caribbean region. Such statistics suggest that beyond additional HIV education and condom promotion, there is a compelling need to integrate new HIV prevention strategies that have recently gained consensus and evidence of efficacy. One approach that the Government of Haiti is considering is newborn medical male circumcision (NMMC). While NMMC could generate significant reduction in future HIV/STI transmission in Haiti, its effectiveness depends on widespread access and population-level uptake. How best to increase uptake among parents of newborn males, particularly in Haiti, has not been explored. However, the determinants of health decisions in resource-limited settings are increasingly being elucidated. One model, the integrative model of behavioral prediction, posits that the key factors include individual attitudes, community norms and self-efficacy. These factors can be strengthened and modified to increase an individual's intent and behavioral action. Our group has successfully used this model to create a video-based educational intervention that reduced the rate of new STIs in clinic patients in the U.S. We will adapt that model and the intervention development process to address uptake of NMMC among parents of newborn boys in urban Haiti by developing and pilot testing a brief video based educational intervention to promote NMMC. The proposed study is innovative and is likely to have high public health importance because this will be the first study to test acceptability of NMMC for future HIV/STI prevention in Haiti.

Public Health Relevance

The World Health Organization and the American Academy of Pediatrics have endorsed the safety and long- term benefits of newborn medical male circumcision (NMMC), and international HIV prevention policy making institutions have advocated further research on its promotion and integration in countries highly affected by the HIV epidemic. This is very much the case in Haiti, which has the most people living with HIV in the Caribbean. Thus, there is a critical need for low cost strategies to slow the HIV epidemic, and increased demand for and participation in interventions like NMMC has large public health implications.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Exploratory/Developmental Grants (R21)
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Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
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Siberry, George K
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Florida International University
Schools of Public Health
United States
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Bristow, Claire C; Lee, Sung-Jae; Severe, Linda et al. (2016) Attributes of diagnostic tests to increase uptake of dual testing for syphilis and HIV in Port-au-Prince, Haiti. Int J STD AIDS :
Bristow, Claire C; Severe, Linda; Pape, Jean William et al. (2016) Dual rapid lateral flow immunoassay fingerstick wholeblood testing for syphilis and HIV infections is acceptable and accurate, Port-au-Prince, Haiti. BMC Infect Dis 16:302
Kojima, Noah; Bristow, Claire C; Pollock, Neil et al. (2015) Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting. Glob Pediatr Health 2:2333794X15589114
Dévieux, Jessy G; Saxena, Anshul; Rosenberg, Rhonda et al. (2015) Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC) among a Sample of Health Care Providers in Haiti. PLoS One 10:e0134667