博茨瓦纳男性自愿接受医学包皮环切术后性活动的早期恢复:一项定性研究。

Early resumption of sexual activity following voluntary medical male circumcision in Botswana: A qualitative study.

作者信息

Ledikwe Jenny H, Ramabu Nankie M, Spees Lisa P, Barnhart Scott, Ntsuape Conrad, Semo Bazghina-Werq, Wirth Kathleen E

机构信息

Department of Global Health, University of Washington, Seattle, Washington, United States of America.

Botswana International Training and Education Center for Health (I-TECH), Gaborone, Botswana.

出版信息

PLoS One. 2017 Nov 14;12(11):e0186831. doi: 10.1371/journal.pone.0186831. eCollection 2017.

Abstract

Unprotected sexual intercourse after undergoing voluntary medical male circumcision but prior to complete wound healing can lead to major adverse events including HIV acquisition. To better understand perceptions related to early resumption of sex prior to wound healing, 27 focus group discussions were conducted among 238 adult men, women, and community leaders in Botswana. Median age among all participants was 31 years of whom 60% were male and 51% were either employed and receiving salary or self-employed. Only 12% reported being currently married. Pain, not risk of HIV acquisition, was perceived as the main adverse consequence of early resumption of sex. In fact, no participant mentioned that early resumption of sex could lead to an increase in HIV risk. Demonstrating masculinity and virility, fear of losing female partners, and misperception about post-operative wound healing also played key roles in the decision to resume sex prior to complete wound healing. Findings from this study highlight a potentially widespread lack of awareness of the increased risk of HIV acquisition during the wound healing period. Strengthening post-operative counseling and identifying strategies to discourage the early resumption of sex will be increasingly important as older men and HIV-positive men seek voluntary medical male circumcision services.

摘要

在自愿接受男性包皮环切术后但伤口尚未完全愈合前进行无保护性行为,可能会导致包括感染艾滋病毒在内的重大不良事件。为了更好地了解与伤口愈合前过早恢复性行为相关的认知情况,在博茨瓦纳对238名成年男性、女性和社区领袖进行了27次焦点小组讨论。所有参与者的年龄中位数为31岁,其中60%为男性,51%受雇领薪或为个体经营者。只有12%的人报告目前已婚。人们认为过早恢复性行为的主要不良后果是疼痛,而非感染艾滋病毒的风险。事实上,没有参与者提到过早恢复性行为会导致感染艾滋病毒的风险增加。展现男子气概和性能力、害怕失去女性伴侣以及对术后伤口愈合的误解,在伤口未完全愈合前就决定恢复性行为的过程中也起到了关键作用。这项研究的结果凸显出在伤口愈合期间,人们可能普遍缺乏对感染艾滋病毒风险增加的认识。随着老年男性和艾滋病毒阳性男性寻求自愿男性包皮环切服务,加强术后咨询并确定阻止过早恢复性行为的策略将变得越来越重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2d3/5685600/c1631bb9981f/pone.0186831.g001.jpg

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