{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:22:42Z","timestamp":1765354962523,"version":"3.40.5"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\/National Institute of Mental Health","award":["R34MH121111 and R01MH095539"],"award-info":[{"award-number":["R34MH121111 and R01MH095539"]}]},{"DOI":"10.13039\/100000060","name":"NIH\/National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["P30AI073961"],"award-info":[{"award-number":["P30AI073961"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009643","name":"National Academies of Sciences, Engineering, and Medicine","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009643","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000025","name":"NIMH","doi-asserted-by":"crossref","award":["R36MH127838"],"award-info":[{"award-number":["R36MH127838"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Voluntary Medical Male Circumcision (VMMC) is an effective strategy for HIV prevention in areas with high prevalence of, and risk for, HIV. More than 361,000 male neonates are born each year in Zambia, many of whom could be eligible for Early-Infant Medical Circumcision (EIMC). Building on successful implementation strategies utilized in our Spear &amp; Shield program, this pilot study, \u201cLike Father, Like Son\u201d (LFLS), evaluated the feasibility and acceptability of offering combined EIMC and VMMC services and couple-level behavioral interventions. A total of <jats:italic>N<\/jats:italic> = 702 pregnant women and their male partners (<jats:italic>n<\/jats:italic> = 351 couples) were recruited and enrolled. Couples were assessed twice pre-birth, 2 weeks post birth, and 6 months post birth. Expectant mothers were an average of 15.05 weeks pregnant (<jats:italic>SD<\/jats:italic> = 8.83). Thirty-nine pregnancies did not result in a live birth (11%), 14 couples withdrew from the study or were lost to follow-up prior to delivery (4%), and 148 babies were born female (42%), leaving 150 couples with a male infant in the analytic sample (43%). The LFLS study achieved significantly higher EIMC rates (35%) in comparison with previously observed EIMC study rates in Zambia (11%), and significantly higher than hypothetical comparison rates up to 30%. Relative to baseline rates, odds of VMMC among couples\u2019 older sons increased by 31% at post-intervention and by 90% at two-weeks following birth. Overall, this pilot study found the LFLS intervention to be feasible, acceptable, and effective in doubling the rate of EIMC in comparison with a previous longitudinal study in Zambia. Future research should consider a family-centric approach to promotion of male circumcision for infants and adolescents. LFLS may be effective in promoting father-son \u201cbonding\u201d by MC status; a bond that may be a bridge to increase both EIMC and VMMC uptake in newborns and couples\u2019 older sons and is a novel leverage point for promotion of this HIV prevention strategy.<\/jats:p>","DOI":"10.1371\/journal.pone.0289819","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T17:33:38Z","timestamp":1691688818000},"page":"e0289819","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Increasing early infant male circumcision uptake in Zambia: Like father like son"],"prefix":"10.1371","volume":"18","author":[{"given":"Stephen M.","family":"Weiss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8543-2061","authenticated-orcid":true,"given":"Violeta J.","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan R.","family":"Cook","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasonde","family":"Bowa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Zulu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Mweemba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Royd","family":"Kamboyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-9449","authenticated-orcid":true,"given":"Victoria Orrego","family":"Dunleavy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria L.","family":"Alcaide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4106-8891","authenticated-orcid":true,"given":"Deborah L.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"issue":"11","key":"pone.0289819.ref001","doi-asserted-by":"crossref","first-page":"e298","DOI":"10.1371\/journal.pmed.0020298","article-title":"Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial","volume":"2","author":"B Auvert","year":"2005","journal-title":"PLoS Med"},{"issue":"9562","key":"pone.0289819.ref002","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0140-6736(07)60312-2","article-title":"Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial","volume":"369","author":"RC Bailey","year":"2007","journal-title":"Lancet"},{"issue":"9562","key":"pone.0289819.ref003","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(07)60313-4","article-title":"Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial","volume":"369","author":"RH Gray","year":"2007","journal-title":"Lancet"},{"issue":"5","key":"pone.0289819.ref004","doi-asserted-by":"crossref","first-page":"e181","DOI":"10.1016\/S2352-3018(15)00042-9","article-title":"The Spear and Shield intervention to increase the availability and acceptability of voluntary medical male circumcision in Zambia: a cluster randomised controlled trial","volume":"2","author":"SM Weiss","year":"2015","journal-title":"Lancet HIV"},{"issue":"5","key":"pone.0289819.ref005","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1097\/QAD.0b013e3283504a3f","article-title":"The effectiveness of male circumcision for HIV prevention and effects on risk behaviors in a posttrial follow-up study","volume":"26","author":"R Gray","year":"2012","journal-title":"AIDS"},{"key":"pone.0289819.ref006","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1186\/1471-2334-11-253","article-title":"Adult male circumcision as an intervention against HIV: an operational study of uptake in a South African community (ANRS 12126)","volume":"11","author":"P Lissouba","year":"2011","journal-title":"BMC Infect Dis"},{"issue":"18","key":"pone.0289819.ref007","doi-asserted-by":"crossref","first-page":"2899","DOI":"10.1097\/01.aids.0000432444.30308.2d","article-title":"The long-term efficacy of medical male circumcision against HIV acquisition","volume":"27","author":"SD Mehta","year":"2013","journal-title":"Aids"},{"key":"pone.0289819.ref008","unstructured":"National AIDS Council. 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