Gasasira et al. BMC Public Health 2012, 12:134 http://www.biomedcentral.com/1471-2458/12/134 Married men (60%) and those who were in cohabita- tion (49%) were not interested in circumcision. After informing the respondents that studies have shown that circumcision done by trained professionals reduces the risk of HIV infection by 60%, majority of the men sup- ported their son’s MC (79%), and 89% of them preferred to do it at younger age (below 15 years). Determinants of circumcision among non Muslim men In uni variate analysis, people living in four provinces were less likely to be circumcised (OR: = 0.04, 0.41, 0.05, 0.12) compared to the City of Kigali. The men in cohabitation (OR: = 0.34) were also less likely to be cir- cumcised compared to those who were married. Signifi- cant association was found with men having secondary education (OR=: 8), University (OR=: 58) education, and being Protestants (OR=: 2.18). With other factors controlled, being circumcised was significantly associated with men who had either sec- ondary (aOR=: 4), or university education (aOR=: 17), and those who mentioned hygiene as a reason to go for circumcision (aOR=: 4). Other associated factors were living in Southern (aOR=: 0.10), Northern (aOR = 0.09), or Eastern (aOR = 0.17) province, and men who were in cohabitation (aOR=: 0.35) (Table 2). Factors associated with the willingness to circumcise amongst UCM and their support to circumcise their son/s In the uni variate analysis, it was found that younger men (30-39, 20-29, < = 19 years) were more likely to get circumcised compared to the older ones (OR = 2.89, 4.36, 4.76), as well as education, living in Eastern Pro- vince, marital status, MC knowledge, and preventive role of MC also are significantly associated with the willingness to circumcise. Controlling for other factors, except education, all variables mentioned above found to be significantly associated with willingness to circum- cise (Table 3). However, only MC knowledge (aOR = 1.63, 2.46), the role of MC on STI prevention (aOR = 2.82), and improved hygiene (aOR = 2.20), were significantly asso- ciated with the willingness to get their sons circumcised. On the other hand, Adventists were less likely to cir- cumcise their son/s compared to the Catholics (aOR: = 0.53) (Table 3). Discussion This community based study presents the determinants of circumcision and willingness to circumcision among men in Rwanda. The overall prevalence of circumcision was 17% among study population but varied from pro- vinces and districts. The city of Kigali has the highest prevalence (52%) followed by the Western province. There is an increase in national and provincial Primary and vocational 1.61 (0.86, 3.03) Variable Age group 40+ 30-39 20-29 ≤ 19 Education No education Secondary University Religion Catholic Protestant Adventist Others Province City of Kigali Southern Western Northern Eastern Marital Status Married Cohabiting Single/Living alone Reasons to circumcise STI/HIV (No) STI/HIV (Yes) Hygiene (No) Hygiene (Yes) Crude OR (95% CI) 1.00 1.43 (0.91, 2.26) 1.22 (0.77, 1.93) 1.11 (0.62, 1.98) 1.00 7.73 (3.84, 15.58)*** 57.73 (16.76, 198.88) *** 1.00 2.18 (1.5, 3.16)*** 1.04 (0.54, 2.02) 3.19 (0.98, 10.35)* 1.00 0.04 (0.02, 0.09)*** 0.41 (0.25, 0.67)*** 0.05 (0.02, 0.12)*** 0.12 (0.06, 0.23)*** 1.00 0.34 (0.17, 0.68)** 1.42 (0.98, 2.04) Adjusted OR (95% CI) 1.00 0.82 (0.46, 1.45) 0.67 (0.34, 1.31) 0.34 (0.13, 0.85)* 1.00 1.26 (0.62, 2.57) 4.01 (1.77, 9.39)*** 17.07 (4.06, 71.82)*** 1.00 1.54 (0.97, 2.44) 0.69 (0.32, 1.47) 2.05 (0.45, 9.30) 1.00 0.10 (0.04, 0.23)*** 0.08 (0.43, 1.47) 0.09 (0.04, 0.22)*** 0.17 (0.08, 0.37)*** 1.00 0.35 (0.16, 0.76)** 1.72 (0.89, 3.35) Page 5 of 8 Table 2 Determinants of circumcision among non Muslim men, 2010 1.00 1.00 2.18 (1.41, 3.37)*** 1.65 (0.99, 2.76) 5.08 (3.39, 7.61)*** 4.18 (2.63, 6.63)*** 1.00 1.00 Significant at *P≤0.05, **P≤0.01, ***P≤0.001 circumcision rate compared to previous two surveys conducted in Rwanda, the Demographic Health Survey 2005 (9%) and the Intermediate Demographic Health Survey 2008 (12%). However, in 2008 survey, the city of Kigali (35.3%) and the Western Province (18%) had the highest prevalence compared to other provinces [9,10]. The reason for high acceptance rate of circumcision in the City of Kigali is because of the coupling effect of access to information and education compared to other provinces. After the publication of the studies carried out in Kenya, Uganda and South Africa concluding that male circumcision can prevent heterosexual HIV infec- tion from female to male up to 60% [2-4], both print