PSYCHOSOCIAL PREDICTORS OF ADOLESCENT ATTITUDES AND POST-CIRCUMCISION BEHAVIORAL INTENTIONS WITHIN SECONDARY SCHOOLS OF MIGORI COUNTY, KENYA

Abstract

This study examined psychosocial predictors of adolescents’ attitudes and post‑circumcision behavioral intentions among circumcised male secondary school students in Migori County, Kenya. The work was motivated by the “Migori paradox,” whereby the county records high VMMC coverage (66.7%) alongside disproportionately high HIV prevalence (13.0%). Guided by the Theory of Planned Behavior, the study investigated how VMMC‑related knowledge and HIV risk perception relate to adolescent attitudes toward circumcision and to undesired behavior intentions within school settings. A descriptive cross‑sectional design was used, and 375 circumcised male students in Forms Two to Four were selected through stratified random sampling across ten sub‑counties. Data were collected using structured questionnaires and analyzed with SPSS Version 25.0. Findings showed high factual knowledge: 87.7% of respondents correctly indicated that VMMC reduces HIV risk. However, 83.2% reported feeling safer in romantic relationships after circumcision, revealing a gap between understanding partial protection and how protection is interpreted in practice. Multiple regression analysis indicated that perceived behavioral control (β = 0.524, p < .001) and attitude (β = 0.335, p < .001) were the strongest predictors of undesired behavioral tendencies, while subjective norms had a marginal effect (β = 0.229, p = .052). The overall model was significant and explained 43.2% of the variance in behavioral outcomes (F = 50.97, p < .001). The study concludes that perceived behavioral control and attitude are central correlates of adolescents’ undesired behavior after circumcision, and that high knowledge alone does not prevent an “illusion of immunity.” It recommends integrating structured behavioral counseling, self‑regulation and self‑efficacy training, and balanced risk communication into school‑based VMMC programmes, and calls for further research on female perspectives and digital media influences on post‑VMMC attitudes and norms.