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Background: Female genital mutilation/cutting (FGM/C) is a traditional harmful practice that has been prevalent in Egypt for many years. The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explored the drivers and motives behind why healthcare professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters. Methods: The study drew on a “mystery client” approach, coupled with in-depth interviews (IDIs) and focus group discussions (FGDs) with health care providers (i.e. physicians and nurses) and mothers. It was conducted in three geographic areas in Egypt: Cairo, Assiut and Al Gharbeya. Results: Study findings suggest that parents who seek medicalized cutting often do so to minimize health risks while conforming to social expectations. Thus, the factors that support FGM/C overlap with the factors that support medicalization. For many mothers and healthcare providers, adherence to community customs and traditions was the most important motive to practice FGM/C. Also, the social construction of girls’ well-being and bodily beauty makes FGM/C a perceived necessity which lays the ground for stigmatization against uncut girls. Finally, the language around FGM/C is being reframed by many healthcare providers as a cosmetic surgery. Such reframing may be one way for providers to overcome the law against FGM/C and market the operation to the clients. Conclusion: These contradictions and contestations highlighted in this study among mothers and healthcare providers suggest that legal, moral and social norms that underpin FGM/C practice are not harmonized and would thus lead to a further rise in the medicalization of FGM/C. This also highlights the critical role that health providers can play in efforts to drive the abandonment of FGM/C in Egypt.

Background: Female genital mutilation/cutting (FGM/C) is a traditional harmful practice that has been prevalent in Egypt for many years. The medicalization of FGM/C has been increasing significantly in Egypt making it the country with the highest rate of medicalization. In this qualitative study, we explored the drivers and motives behind why healthcare professionals perform FGM/C and why mothers rely on them to perform the practice on their daughters. Methods: The study drew on a “mystery client” approach, coupled with in-depth interviews (IDIs) and focus group discussions (FGDs) with health care providers (i.e. physicians and nurses) and mothers. It was conducted in three geographic areas in Egypt: Cairo, Assiut and Al Gharbeya. Results: Study findings suggest that parents who seek medicalized cutting often do so to minimize health risks while conforming to social expectations. Thus, the factors that support FGM/C overlap with the factors that support medicalization. For many mothers and healthcare providers, adherence to community customs and traditions was the most important motive to practice FGM/C. Also, the social construction of girls’ well-being and bodily beauty makes FGM/C a perceived necessity which lays the ground for stigmatization against uncut girls. Finally, the language around FGM/C is being reframed by many healthcare providers as a cosmetic surgery. Such reframing may be one way for providers to overcome the law against FGM/C and market the operation to the clients. Conclusion: These contradictions and contestations highlighted in this study among mothers and healthcare providers suggest that legal, moral and social norms that underpin FGM/C practice are not harmonized and would thus lead to a further rise in the medicalization of FGM/C. This also highlights the critical role that health providers can play in efforts to drive the abandonment of FGM/C in Egypt.

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Objectives: To explore the attitude of health care providers about screening for and dealing with domestic violence in the health care setting and to assess the physicians screening behavior. Methods: We surveyed physicians and nurses working in diferent departments of Assiut University Hospital using a self-administered questionnaire.Two focus group discussions with physicians and nurses were also conducted. Results: 44.3% and 46.5% of physicians and nurses mentioned time constraints as a barrier for DV screening. Physicians believed that it is not important to screen for DV because it is a socially accepted problem and because of the unavailability of the necessary referrals to help victims(30.2% and 20.0%,respectively).The unsuitability of the outpatient clinics to screen for DV was also mentioned by 65.6% and 75.5% of physicians and nurses respectively. Only 36.7% of physicians perceived having the communication skills to facilitate disclosure of DV exposure. Regarding practice,only 35.0% of physicians have screened for DV in the three months preceding data collection. Urban residence, perception of the negative health consequence of DV exposure and perception of the physicians to have the required communication skills predicted positive attitude towards DV screening, while feeling distressed to discuss exposure to DV was associated with negative physicians’ attitude. Conclusion: In-service training of healthcare providers to identify and manage victims of DV and establishing supportive system would have great implications for reducing the physical and mental negative consequences of DV exposure.

Objectives: To explore the attitude of health care providers about screening for and dealing with domestic violence in the health care setting and to assess the physicians screening behavior. Methods: We surveyed physicians and nurses working in diferent departments of Assiut University Hospital using a self-administered questionnaire.Two focus group discussions with physicians and nurses were also conducted. Results: 44.3% and 46.5% of physicians and nurses mentioned time constraints as a barrier for DV screening. Physicians believed that it is not important to screen for DV because it is a socially accepted problem and because of the unavailability of the necessary referrals to help victims(30.2% and 20.0%,respectively).The unsuitability of the outpatient clinics to screen for DV was also mentioned by 65.6% and 75.5% of physicians and nurses respectively. Only 36.7% of physicians perceived having the communication skills to facilitate disclosure of DV exposure. Regarding practice,only 35.0% of physicians have screened for DV in the three months preceding data collection. Urban residence, perception of the negative health consequence of DV exposure and perception of the physicians to have the required communication skills predicted positive attitude towards DV screening, while feeling distressed to discuss exposure to DV was associated with negative physicians’ attitude. Conclusion: In-service training of healthcare providers to identify and manage victims of DV and establishing supportive system would have great implications for reducing the physical and mental negative consequences of DV exposure.

Background: HIV/AIDS is highly prevalent among youth. Inadequate knowledge and major misconceptions related to HIV/AIDS among adolescents/ youth including university students would increase its transmission. Objectives: This study aimed to assess knowledge about HIV/AIDS and its determinants among Assiut University students. Methods: A cross-sectional study was carried out on representative sample of 776 students in Assiut University. A multistage stratified cluster sampling technique was used. A self- administered questionnaire was used to collect data. HIV/AIDs knowledge was assessed and a knowledge score was calculated. Results: Only 70.5% of Assiut University students have heard about AIDS. The main sources of the students’ knowledge were media (46.3%), internet (44.6 %), school (28 %), university educational courses and health education sessions (27.8 %), friends (23.9 %) and family (22.5 %). The students in the study had a low knowledge score of 35 percent. Some misconceptions about transmission were observed such as AIDS transmission by mosquito bite (30%), hugging (19%), eating with infected person (17.5%) or being a hereditary disease (16%). Only 18% know that condoms would protect from HIV infection and 28% knew that patients could look 2 normal without symptoms. Only 45.2% of the students knew HIV testing site. By applying Logistic regression analysis, the predictors of higher knowledge score about HIV/AIDS were being a medical faculty student, higher (fourth) grade, urban residence and family/university as sources of information. Conclusion and recommendation: University students AIDS related knowledge is inadequate. The role of university as an important source of raising awareness of the university students should be activated by including AIDS related topics into the curriculum and conducting counseling and health awareness sessions especially in non-medical faculties. Also, efforts should be directed to approach the youth families and youth residing in rural areas and raising their awareness.

Background: HIV/AIDS is highly prevalent among youth. Inadequate knowledge and major misconceptions related to HIV/AIDS among adolescents/ youth including university students would increase its transmission. Objectives: This study aimed to assess knowledge about HIV/AIDS and its determinants among Assiut University students. Methods: A cross-sectional study was carried out on representative sample of 776 students in Assiut University. A multistage stratified cluster sampling technique was used. A self- administered questionnaire was used to collect data. HIV/AIDs knowledge was assessed and a knowledge score was calculated. Results: Only 70.5% of Assiut University students have heard about AIDS. The main sources of the students’ knowledge were media (46.3%), internet (44.6 %), school (28 %), university educational courses and health education sessions (27.8 %), friends (23.9 %) and family (22.5 %). The students in the study had a low knowledge score of 35 percent. Some misconceptions about transmission were observed such as AIDS transmission by mosquito bite (30%), hugging (19%), eating with infected person (17.5%) or being a hereditary disease (16%). Only 18% know that condoms would protect from HIV infection and 28% knew that patients could look 2 normal without symptoms. Only 45.2% of the students knew HIV testing site. By applying Logistic regression analysis, the predictors of higher knowledge score about HIV/AIDS were being a medical faculty student, higher (fourth) grade, urban residence and family/university as sources of information. Conclusion and recommendation: University students AIDS related knowledge is inadequate. The role of university as an important source of raising awareness of the university students should be activated by including AIDS related topics into the curriculum and conducting counseling and health awareness sessions especially in non-medical faculties. Also, efforts should be directed to approach the youth families and youth residing in rural areas and raising their awareness.

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