Mantell Joanne E, Smit Jennifer A, Saffitz Jane L, Milford Cecilia, Mosery Nzwakie, Mabude Zonke, Tesfay Nonkululeko, Sibiya Sibusiso, Rambally Letitia, Masvawure Tsitsi B, Kelvin Elizabeth A, Stein Zena A
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA.
Sex Health. 2013 May;10(2):112-8. doi: 10.1071/SH12067.
Medical male circumcision (MMC) reduces the risk of HIV acquisition for men in heterosexual encounters by 50-60%. However, there is no evidence that a circumcised man with HIV poses any less risk of infecting his female partner than an uncircumcised man. There may be an additional risk of HIV transmission to female partners during the 6-week healing period and if condoms are used less often after circumcision. The aim was to explore young women's perspectives on MMC, with a view to developing clear messages about the limitations of MMC in reducing women's HIV risk.
We explored women's perspectives on MMC in KwaZulu-Natal, South Africa, with a sample of 30 female tertiary students via four focus groups (two for women only; two mixed gender).
In all groups, women communicated a thorough understanding of the partial efficacy of MMC, but believed that others would not understand this concept. Participants noted that MMC affords no direct benefit to women. Most thought that MMC would increase females' risk of contracting HIV, that circumcised men may engage in risky behaviours and that men would increase their number of sexual partners after circumcision. Participants believed that condom use would decrease after MMC and speculated that men would have sex during the healing period, which could further compromise women's sexual health.
The concerns expressed by women regarding MMC highlight the need for including women in the dialogue about MMC and for clarifying the impact of MMC on HIV risk for women.
医学男性包皮环切术可将异性性行为中男性感染艾滋病毒的风险降低50%-60%。然而,没有证据表明感染艾滋病毒的包皮环切男性传染其女性伴侣的风险比未环切男性更低。在六周的愈合期内以及包皮环切术后如果较少使用避孕套,可能会增加将艾滋病毒传播给女性伴侣的风险。目的是探讨年轻女性对医学男性包皮环切术的看法,以便就医学男性包皮环切术在降低女性艾滋病毒风险方面的局限性制定明确的信息。
我们在南非夸祖鲁-纳塔尔省,通过四个焦点小组(两个仅为女性小组;两个混合性别小组),对30名女大学生进行抽样,探讨女性对医学男性包皮环切术的看法。
在所有小组中,女性都表达了对医学男性包皮环切术部分疗效的透彻理解,但认为其他人不会理解这一概念。参与者指出,医学男性包皮环切术对女性没有直接益处。大多数人认为医学男性包皮环切术会增加女性感染艾滋病毒的风险,包皮环切的男性可能会从事危险行为,并且男性在包皮环切术后会增加性伴侣数量。参与者认为在医学男性包皮环切术后避孕套的使用会减少,并推测男性会在愈合期发生性行为,这可能会进一步损害女性的性健康。
女性对医学男性包皮环切术表达的担忧凸显了让女性参与关于医学男性包皮环切术的对话以及阐明医学男性包皮环切术对女性艾滋病毒风险影响的必要性。