Bailey R C, Muga R, Poulussen R, Abicht H
School of Public Health, University of Illinois at Chicago, USA.
AIDS Care. 2002 Feb;14(1):27-40. doi: 10.1080/09540120220097919.
Compelling epidemiological evidence showing a significant association between lack of male circumcision and HIV infection has prompted calls for consideration of male circumcision interventions as a strategy for reducing HIV prevalence in highly affected areas where circumcision is little practiced and transmission is predominantly heterosexual. Little is known about whether male circumcision interventions would be acceptable or feasible in traditionally non-circumcisng areas of Africa. This study assesses the acceptability of male circumcision in the Luo, a large, traditionally non-circumcising ethnic group in western Kenya. Separate focused group discussions with adult Luo men and women and semi-structured interviews with clinicians were conducted in Nyanza Province, Kenya. The primary barriers to acceptance of male circumcision were cultural identification, fear of pain and excessive bleeding and cost. The main facilitators were association of male circumcision with better hygiene and reduced risk of infection. Both men and women were eager for promotion of genital hygiene and male circumcision, and they desired availability of circumcision clinical services in the Province's health facilities. Clinicians lacked the knowledge and resources to offer safe circumcision counselling and services. If results from this study are valid for other areas of sub-Saharan Africa, acceptability of male circumcision as a means to reduce STDs and HIV is higher than previously suspected. Further studies are needed in other regions to assess the feasibility of introducing acceptable male circumcision information and services to reduce HIV transmission.
有力的流行病学证据表明，男性未行包皮环切术与感染艾滋病毒之间存在显著关联，这促使人们呼吁考虑将男性包皮环切术干预措施作为一种策略，以降低在包皮环切术施行较少且传播主要为异性传播的高感染地区的艾滋病毒流行率。对于男性包皮环切术干预措施在非洲传统上不行包皮环切术的地区是否可接受或可行，人们知之甚少。本研究评估了肯尼亚西部一个传统上不行包皮环切术的大型族群——卢奥族对男性包皮环切术的接受程度。在肯尼亚的尼扬扎省，分别与成年卢奥族男性和女性进行了焦点小组讨论，并对临床医生进行了半结构化访谈。接受男性包皮环切术的主要障碍是文化认同、对疼痛和出血过多的恐惧以及费用。主要的促进因素是将男性包皮环切术与更好的卫生状况和降低感染风险联系起来。男性和女性都渴望推广生殖器卫生和男性包皮环切术，并且他们希望该省的医疗机构能够提供包皮环切术临床服务。临床医生缺乏提供安全包皮环切术咨询和服务的知识和资源。如果本研究的结果对撒哈拉以南非洲的其他地区有效，那么男性包皮环切术作为降低性传播疾病和艾滋病毒感染手段的可接受性高于先前的推测。需要在其他地区进行进一步研究，以评估引入可接受的男性包皮环切术信息和服务以减少艾滋病毒传播的可行性。
