Knowledge, Attitudes, and Perceptions Towards Male Circumcision Among Men Aged 20-40 Years in Otjiwarongo, Otjozondjupa Region, Namibia.

Male circumcision (MC) has been shown in studies from South Africa, Kenya, and Uganda to reduce heterosexual Human Immunodeficiency Virus (HIV) transmission among men by approximately 50-60%. Despite Namibia's adoption of voluntary medical male circumcision (VMMC) as part of national HIV prevention strategies, uptake remains suboptimal in some communities. This study assessed the knowledge, attitudes, and perceptions (KAP) of male circumcision among men aged 20-40 years in Otjiwarongo, Namibia, and examined socio-demographic factors associated with these outcomes. A community-based cross-sectional survey was conducted between March and May 2024, involving 359 participants selected through multistage sampling. Data were collected using structured, pre-tested questionnaires and analysed using STATA version 19. Descriptive statistics, chi-square tests, and binary logistic regression were used to summarise data and identify predictors of favourable KAP outcomes. Overall, 69.1% of respondents demonstrated good knowledge of male circumcision, 72.7% had positive attitudes, and 69.9% reported positive perceptions. Awareness of male circumcision was high (91.9%); however, only 69.4% of participants recognised its role in reducing HIV infection risk, and notable misconceptions persisted regarding its protective effects and procedural aspects. Multivariable analysis showed that urban residence (AOR = 1.58; 95% CI: 1.03-2.42; p = 0.035) and higher education (AOR = 4.12; 95% CI: 1.21-14.02; p = 0.024) were significant predictors of favourable KAP outcomes. In addition, good knowledge was strongly associated with positive attitudes (AOR = 3.25; 95% CI: 2.01-5.26; p < 0.001) and perceptions (AOR = 2.87; 95% CI: 1.79-4.60; p < 0.001). In conclusion, while knowledge, attitudes, and perceptions towards male circumcision were generally favourable, important gaps and misconceptions remain. Targeted, culturally appropriate health education interventions are needed, particularly among rural and less-educated populations, to improve understanding and acceptance of VMMC as part of comprehensive HIV prevention strategies.