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To enhance HIV prevention in the nation, the Ministry of Health has made efforts to offer voluntary medical male circumcision (VMMC) services in prisons as an intervention to strengthen HIV prevention in the country. However, little is known about the barriers and enablers to the utilisation of VMMC among men who are incarcerated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This phenomenological qualitative study aimed to explore the experiences of men who were incarcerated while utilising prison-based VMMC services at Maula Prison in Lilongwe. Data were collected through interviews with 7 men who are incarcerated and 7 prison staff, resulting in a sample of 14 participants. A thematic content analysis approach was used to analyse data from both men who were incarcerated and prison staff, guided by the social ecological model, to identify individual, interpersonal, and organisational factors influencing VMMC utilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both enablers and barriers to VMMC utilisation were identified. Key enablers included improved hygiene, motivation from peers and prison staff, availability of peer educators in the prison, exemption from hard labour during recovery and the availability of VMMC services within the prison. Major barriers consisted of fear of post-operative pain and complications, stigma and mockery from peers, spread of misconceptions about VMMC, shortages of healthcare personnel, limited VMMC-specific training among healthcare workers, overcrowded prison cells, and inadequate post-operative support resources such as soap, water, and nutritious food.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study concluded that while VMMC is generally acceptable among men who are incarcerated, utilisation is shaped by a combination of individual knowledge, interpersonal influences, and organisational conditions within the prison environment. Addressing these multilevel barriers is essential to enhancing VMMC utilisation among men who are incarcerated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-026-26313-8","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:23:06Z","timestamp":1768954986000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers and enablers to the utilisation of prison-based voluntary medical male circumcision (VMMC) among incarcerated men: a qualitative study from Maula Prison, Malawi"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6482-1491","authenticated-orcid":false,"given":"Nelson Tengamowa","family":"Munthali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Musiige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Mtambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thokozire","family":"Chirambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lot","family":"Nyirenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"26313_CR1","unstructured":"UNAIDS, Global HIV & AIDS statistics \u2014 Fact sheet n.d. https:\/\/www.unaids.org\/en\/resources\/fact-sheet. 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Lancet. 2016;388:1215\u201327.","journal-title":"Lancet"},{"key":"26313_CR59","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1007\/s10461-011-0073-1","volume":"16","author":"A Herman-Roloff","year":"2012","unstructured":"Herman-Roloff A, Bailey RC, Agot K Factors associated with the early resumption of sexual activity following medical male circumcision in Nyanza Province, Kenya. AIDS Behav. 2012;16:1173\u201381. https:\/\/doi.org\/10.1007\/s10461-011-0073-1.","journal-title":"AIDS Behav"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-026-26313-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-26313-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-26313-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:53:20Z","timestamp":1781628800000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-026-26313-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":59,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["26313"],"URL":"https:\/\/doi.org\/10.1186\/s12889-026-26313-8","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"assertion":[{"value":"20 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Conducting qualitative research with incarcerated participants is ethically justifiable and important because it gives voice to a marginalised population whose lived experiences may reveal essential insights about health issues in prisons. The study was conducted at Maula Prison in Malawi, with ethical approval sought from the College of Medicine Research and Ethics Committee (COMREC) approval number P11\/23\u20130468, and permission from the Malawi Prisons Authority. All research procedures were conducted in accordance with the ethical standards of COMREC and the principles outlined in the Declaration of Helsinki. Men who are incarcerated, being a vulnerable population, the researcher ensured that their status would not influence their responses by ensuring that interviews were conducted in a private room where only the researcher and participants were present. Participants were informed of the nature, purpose, benefits, and risks associated with the study. The informed consent form was made available in English and Chichewa, and participants were given the option to withdraw at any time. Participation was voluntary, such that the researcher made sure that the participation was not influenced by their prison status. The consent forms adopted the formats for both literate and illiterate subjects as per COMREC and WHO research standards. For anonymity, no names of participants were used in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"608"}}