Nkosi Sebenzile, Sikweyiya Yandisa, Kekwaletswe Connie T, Morojele Neo K
a Alcohol, Tobacco, & Other Drug Research Unit , Medical Research Council , Pretoria , South Africa.
AIDS Care. 2015;27(5):612-7. doi: 10.1080/09540121.2014.983040. Epub 2014 Nov 27.
Strong research evidence has shown that medical male circumcision significantly reduces heterosexual HIV acquisition among men. However, its effectiveness is enhanced by behavioural factors such as condom use. Currently, little is known of unprotected sex associated with male circumcision (MC) among alcohol-drinking tavern-going men, or whether engagement in unprotected sex may differ between men who have been traditionally circumcised and those who have been medically circumcised. The study sought to determine the relative importance of alcohol consumption and MC as correlates of unprotected sex and to compare the risk of engaging in unprotected sex between traditionally circumcised and medically circumcised tavern-going men from two rural villages in North-West province, South Africa. Data from 314 adult men (≥18 years) were analysed. The men were recruited from four bars/taverns using systematic sampling. They responded to questions regarding their demographic characteristics, alcohol consumption, circumcision status and method (where applicable), and engagement in unprotected sex. Descriptive analyses and bivariate and multivariate logistic regression analyses were conducted. Age, education, relationship status, alcohol consumption and traditional male circumcision (TMC) were independently and significantly associated with unprotected sex. Specifically, probable alcohol dependence and traditional circumcision were independent risk factors for engaging in unprotected sex among tavern-going men. Traditionally circumcised men had a higher risk of engaging in unprotected sex than medically circumcised men. Interventions aimed at reducing alcohol consumption, encouraging protective behaviour among men who have undergone TMC, and increasing condom use are needed in bar/tavern settings. HIV prevention education must be urgently incorporated into TMC programmes.
强有力的研究证据表明,男性医学包皮环切术可显著降低男性通过异性性行为感染艾滋病毒的几率。然而,诸如使用避孕套等行为因素可增强其效果。目前,对于在酒馆饮酒的男性中,与男性包皮环切术(MC)相关的无保护性行为情况,或者传统包皮环切术男性与医学包皮环切术男性在无保护性行为方面是否存在差异,人们知之甚少。该研究旨在确定饮酒和男性包皮环切术作为无保护性行为相关因素的相对重要性,并比较南非西北省两个乡村中,传统包皮环切术男性与医学包皮环切术男性在酒馆饮酒时发生无保护性行为的风险。对314名成年男性(≥18岁)的数据进行了分析。这些男性通过系统抽样从四个酒吧/酒馆招募而来。他们回答了有关其人口统计学特征、饮酒情况、包皮环切状态及方式(如适用)以及无保护性行为情况的问题。进行了描述性分析、双变量和多变量逻辑回归分析。年龄、教育程度、恋爱状况、饮酒情况和传统男性包皮环切术(TMC)与无保护性行为独立且显著相关。具体而言,可能的酒精依赖和传统包皮环切术是酒馆饮酒男性发生无保护性行为的独立危险因素。传统包皮环切术男性发生无保护性行为的风险高于医学包皮环切术男性。在酒吧/酒馆环境中,需要采取干预措施来减少饮酒、鼓励接受传统包皮环切术男性的保护行为并增加避孕套的使用。艾滋病毒预防教育必须紧急纳入传统包皮环切术项目。