BACKGROUND Voluntary medical male circumcision (VMMC) is a key component of combination HIV-prevention programmes. Several high-HIV-prevalence countries in sub-Saharan Africa, including Zimbabwe, are looking to scale up VMMC activities. There is limited evidence on how a combination of social learning from peer education by a role model with different behavioural incentives influences demand for VMMC in such settings. METHODS/DESIGN This matched-cluster randomised controlled trial with 1740 participants will compare two behavioural incentives against a control with no intervention. In the intervention clusters, participants will participate in an education session delivered by a circumcised young male ("role model") on the risks of HIV infection and the benefits from medical male circumcision. All participants will receive contributions towards transport costs to access medical male circumcision at participating clinics. Via blocked randomisation, in the intervention clusters participants will be randomly assigned to receive one of two types of incentives - fixed cash payment or lottery payment - both conditional on undergoing surgical VMMC. In two sites, a community-led intervention will also be implemented to address social obstacles and to increase support from peers, families and social structures. Baseline measures of endpoints will be gathered in surveys. Follow-up assessment at 6 months will include self-reported uptake of VMMC triangulated with clinic data. DISCUSSION This is the first trial to pilot-test social learning to improve risk perception and self-efficacy and to address the fear of pain associated with VMMC and possible present-biased preferences with front-loaded compensations as well as fixed or lottery-based cash payments. This study will generate important knowledge to inform HIV-prevention policies about the effectiveness of behavioural interventions and incentives, which could be easily scaled-up. TRIAL REGISTRATION This trial has been registered on ClinicalTrials.gov (identifier: NCT03565588). Registered on 21 June 2018.

中文翻译：

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在东津巴布韦马尼卡兰，通过同伴教育课程和激励措施提高风险认知和自愿医疗男性包皮环切术的接受度：一项试点随机试验的研究方案。


背景 自愿医疗男性包皮环切术（VMMC）是艾滋病毒综合预防计划的关键组成部分。包括津巴布韦在内的撒哈拉以南非洲地区的几个艾滋病毒高流行国家正在寻求扩大 VMMC 活动。关于同伴教育的社会学习与不同行为激励的角色模型相结合如何影响此类环境中对 VMMC 的需求的证据有限。方法/设计 这项 1740 名参与者的匹配集群随机对照试验将比较两种行为激励与无干预的对照。在干预组中，参与者将参加由接受包皮环切术的年轻男性（“榜样”）举办的教育课程，内容涉及艾滋病毒感染的风险以及男性包皮环切术的益处。所有参与者都将获得在参与诊所进行男性包皮环切术的交通费用捐款。通过分块随机化，在干预集群中，参与者将被随机分配接受两种激励措施之一——固定现金支付或彩票支付——两者都以接受手术 VMMC 为条件。在两个地点，还将实施社区主导的干预措施，以解决社会障碍并增加同龄人、家庭和社会结构的支持。端点的基线测量将在调查中收集。 6 个月的后续评估将包括自我报告的 VMMC 吸收情况与临床数据的三角测量。讨论 这是第一个试点社会学习的试验，以提高风险感知和自我效能，并通过预先支付的补偿以及固定或基于彩票的现金来解决与 VMMC 相关的痛苦恐惧和可能存在的偏见偏好付款。 这项研究将产生重要的知识，为艾滋病毒预防政策提供关于行为干预和激励措施有效性的信息，这些干预措施和激励措施可以很容易地扩大规模。试验注册 该试验已在 ClinicalTrials.gov 上注册（标识符：NCT03565588）。注册日期：2018 年 6 月 21 日。