Shi Chyun, Li Michael, Dushoff Jonathan
Department of Biology, McMaster University, Hamilton, ON, Canada.
Department of Mathematics and Statistics, McMaster University, Hamilton, ON, Canada.
AIDS Behav. 2020 Mar;24(3):951-959. doi: 10.1007/s10461-019-02473-0.
To understand the sexual risk behavior of men with traditional male circumcision and medical male circumcision in the context of the World Health Organization's (WHO) campaign for voluntary medical male circumcision (VMMC) scale-up, we investigated ten countries prioritized for the scale-up from the Demographic and Health Surveys. Male respondents aged 15-49 were selected. Ordinal regression was used to analyze the relationship between three sexual risk behaviors-condom use with non-cohabiting partners, number of non-cohabiting partners, and partner type-and circumcision status (traditionally circumcised before and after the VMMC scale-up, medically circumcised before and after the scale-up, and not circumcised), while controlling for social demographic covariates. We found evidence that some sexual risky behavior, specifically lower condom use and higher number of sexual partners, was associated with traditional circumcision. This finding suggests that messages about the protective effect of male circumcision may not have reached men with traditional circumcision. We suggest that WHO's VMMC campaign should include communities where traditional male circumcision is popular. We looked for, but did not find, evidence of differences between groups circumcised at different times, which could have indicated sexual risk compensation.
为了在世界卫生组织（WHO）扩大自愿医学男性包皮环切术（VMMC）的背景下，了解接受传统男性包皮环切术和医学男性包皮环切术的男性的性风险行为，我们对人口与健康调查中优先进行扩大推广的10个国家进行了调查。选取了年龄在15至49岁的男性受访者。采用有序回归分析三种性风险行为（与非同居伴侣使用避孕套、非同居伴侣数量和伴侣类型）与包皮环切状态（在VMMC扩大推广之前和之后接受传统包皮环切术、在扩大推广之前和之后接受医学包皮环切术以及未接受包皮环切术）之间的关系，同时控制社会人口统计学协变量。我们发现有证据表明，一些性风险行为，特别是较低的避孕套使用率和较多的性伴侣数量，与传统包皮环切术有关。这一发现表明，关于男性包皮环切术保护作用的信息可能尚未传达给接受传统包皮环切术的男性。我们建议WHO的VMMC运动应涵盖传统男性包皮环切术流行的社区。我们寻找但未找到不同时间接受包皮环切术的群体之间存在差异的证据，而这种差异可能表明存在性风险补偿。
