Riess Thomas H, Achieng' Maryline M, Bailey Robert C
School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America.
Liverpool VCT, Care and Treatment, Research and Policy Department, Nairobi, Kenya.
PLoS One. 2014 May 20;9(5):e97748. doi: 10.1371/journal.pone.0097748. eCollection 2014.
It is important to understand how women's sexual practices may be influenced by male circumcision (MC) as an HIV prevention effort. Women's beliefs about MC and sexual behaviour will likely influence the scale-up and uptake of medical MC. We conducted qualitative interviews with 30 sexually active women in Kisumu, Kenya. Women discussed MC related to perceived health benefits, condom use, sexual behaviour, knowledge of susceptibility to HIV and sexually transmitted infections (STIs), circumcision preference, and influence on circumcision uptake. Respondents had a good understanding of the partial protection of MC for acquisition of HIV for men. Women perceived circumcised men as cleaner, carrying fewer diseases, and taking more time to reach ejaculation. Male's circumcision status is a salient factor for women's sexual decision making, including partner choice, and condom use. It will be important that educational information affirms that MC provides only partial protection against female to male transmission of HIV and some STIs; that other HIV and STI prevention methods such as condoms need to be used in conjunction with MC; that MC does not preclude a man from having HIV; and that couples should develop plans for not having sex while the man is healing.
了解女性的性行为如何受到男性包皮环切术(MC)这一预防艾滋病举措的影响非常重要。女性对男性包皮环切术和性行为的看法可能会影响医学男性包皮环切术的推广和接受程度。我们对肯尼亚基苏木的30名性活跃女性进行了定性访谈。女性们讨论了与男性包皮环切术相关的感知健康益处、避孕套使用、性行为、对感染艾滋病病毒和性传播感染(STIs)易感性的认识、包皮环切术偏好以及对接受包皮环切术的影响。受访者对男性包皮环切术对男性预防感染艾滋病病毒的部分保护作用有很好的理解。女性认为接受包皮环切术的男性更清洁,携带的疾病更少,达到射精的时间更长。男性的包皮环切术状况是女性做出性决策的一个重要因素,包括性伴侣的选择和避孕套的使用。重要的是,教育信息应明确指出,男性包皮环切术仅对女性到男性传播艾滋病病毒和某些性传播感染提供部分保护;其他预防艾滋病病毒和性传播感染的方法,如避孕套,需要与男性包皮环切术结合使用;男性包皮环切术并不能排除男性感染艾滋病病毒的可能性;并且夫妻双方应该制定计划,在男性伤口愈合期间避免性行为。