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自愿医学男性割礼与马拉维姆祖祖活跃性割礼男性性行为:一项横断面研究。

Voluntary medical male circumcision and sexual practices among sexually active circumcised men in Mzuzu, Malawi: a cross-sectional study.

机构信息

College of Medicine, Public Health Department, P/Bag 360, Chichiri, Blantyre 3, Malawi.

Malawi Defence Force, Malawi Military Health Services, Moyale Barracks, P.O Box 23, Mzuzu, Malawi.

出版信息

BMC Public Health. 2020 Feb 11;20(1):211. doi: 10.1186/s12889-020-8309-5.


DOI:10.1186/s12889-020-8309-5
PMID:32046686
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7014635/
Abstract

BACKGROUND: Voluntary Medical Male Circumcision (VMMC) is one of the strategies being promoted to prevent sexual heterosexual transmission of HIV. It has been adopted by 14 countries with high HIV prevalence and low circumcision rates. The 60.0% protective efficacy of VMMC has come with misconceptions in some societies in Malawi, hence VMMC clients may opt for risky sexual practices owing to its perceived protective effect. The study estimated proportion of circumcised men engaging in risky sexual behaviors post-VMMC, assessed knowledge on VMMC protective effect and identified socio-demographic factors associated with risky sexual practices. METHOD: A cross sectional study was conducted at two sites of Mzuzu city. Systematic random sampling was used to select 322 participants aged 18-49 who had undergone VMMC. The independent variables included age, location, occupation, religion, marital status and education. Outcome variables were non condom use, having multiple sexual partners and engaging in transactional sex. Data from questionnaires was analyzed using Pearson's chi square test and logistic regression. RESULTS: Out of 322 respondents, 84.8% (273) understood the partial protection offered by VMMC in HIV prevention. Ninety-six percent of the participants self-reported continued use of condoms post VMMC. Overall 23.7-38.3% participants self-reported engaging in risky sexual practices post VMMC, 23.7% (76) had more than one sexual partner; 29.2% (94) paid for sex while 39.9% (n = 187) did not use a condom. Residing in high density areas was associated with non-condom use, (p = 0.043). Being single (p < 0.001), and residing in low density areas (p = 0.004) was associated with engaging in transactional sex. CONCLUSION: Risky sexual practices are evident among participants that have undergone VMMC. Messages on safer sexual practices and limitations of VMMC need to be emphasized to clients, especially unmarried or single and those residing in low density areas.

摘要

背景:自愿男性包皮环切术(VMMC)是预防异性性传播 HIV 的策略之一。已有 14 个高 HIV 流行率和低割礼率的国家采用了这种策略。VMMC 的 60.0%的保护效果在马拉维的一些社会中存在误解,因此 VMMC 客户可能会因为其被认为的保护效果而选择危险的性行为。这项研究估计了接受 VMMC 后进行危险性行为的割礼男性比例,评估了对 VMMC 保护效果的认识,并确定了与危险性行为相关的社会人口学因素。 方法:在姆祖祖市的两个地点进行了一项横断面研究。采用系统随机抽样方法选择了 322 名年龄在 18-49 岁之间、接受过 VMMC 的参与者。自变量包括年龄、地点、职业、宗教、婚姻状况和教育程度。因变量包括不使用安全套、有多个性伴侣和从事性交易。问卷数据使用 Pearson's chi square 检验和逻辑回归进行分析。 结果:在 322 名受访者中,84.8%(273 人)理解 VMMC 在 HIV 预防中的部分保护作用。96%的参与者报告在 VMMC 后继续使用安全套。总体而言,23.7-38.3%的参与者报告在 VMMC 后进行了危险的性行为,23.7%(76 人)有多个性伴侣;29.2%(94 人)付钱发生性行为,而 39.9%(n=187 人)没有使用安全套。居住在高密度地区与不使用安全套有关(p=0.043)。单身(p<0.001)和居住在低密度地区(p=0.004)与从事性交易有关。 结论:接受过 VMMC 的参与者中存在危险的性行为。需要向客户强调更安全的性行为信息和 VMMC 的局限性,特别是未婚或单身以及居住在低密度地区的客户。

相似文献

[1]
Voluntary medical male circumcision and sexual practices among sexually active circumcised men in Mzuzu, Malawi: a cross-sectional study.

BMC Public Health. 2020-2-11

[2]
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[3]
Correlates of Condom Use and Procedure Knowledge Among Men Accessing Voluntary Medical Male Circumcision in Malawi.

Int J Behav Med. 2017-4

[4]
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[5]
Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010-11 Zimbabwe demographic and health survey.

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[6]
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[7]
A comparison of sexual risk behaviours and HIV seroprevalence among circumcised and uncircumcised men before and after implementation of the safe male circumcision programme in Uganda.

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[8]
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[9]
Sexual Pleasure and Function, Coital Trauma, and Sex Behaviors After Voluntary Medical Male Circumcision Among Men in the Dominican Republic.

J Sex Med. 2017-4

[10]
Differences in risky sexual behaviors and HIV prevalence of circumcised and uncircumcised men in Uganda: evidence from a 2011 cross-sectional national survey.

Reprod Health. 2014-3-24

引用本文的文献

[1]
Prevalence of Paid Sex and Associated Factors Among Women and Men Attending HIV Voluntary Counseling and Testing in Kinshasa, Democratic Republic of the Congo: A Prospective Cohort.

Arch Sex Behav. 2024-10

[2]
Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa.

PLOS Glob Public Health. 2024-5-31

[3]
Factors Influencing Participation of Adults in Voluntary Medical Male Circumcision in Lindi Region, Tanzania.

East Afr Health Res J. 2023

[4]
Understanding the Evolving Role of Voluntary Medical Male Circumcision as a Public Health Strategy in Eastern and Southern Africa: Opportunities and Challenges.

Curr HIV/AIDS Rep. 2022-12

[5]
Barriers, benefits, and behaviour: Voluntary medical male circumcision ideation in a population-based sample of Zambian men.

Afr J AIDS Res. 2021-12

[6]
Key challenges to voluntary medical male circumcision uptake in traditionally circumcising settings of Machinga district in Malawi.

BMC Public Health. 2021-10-28

本文引用的文献

[1]
What Is Required to End the AIDS Epidemic as a Public Health Threat by 2030? The Cost and Impact of the Fast-Track Approach.

PLoS One. 2016-5-9

[2]
Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis.

PLoS Med. 2016-5-3

[3]
Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review.

PLoS One. 2016-3-3

[4]
Estimation of country-specific and global prevalence of male circumcision.

Popul Health Metr. 2016-3-1

[5]
Sexual Risk Behaviours and Willingness to Be Circumcised among Uncircumcised Adult Men in Uganda.

PLoS One. 2015-12-14

[6]
Understanding the socio-economic and sexual behavioural correlates of male circumcision across eleven voluntary medical male circumcision priority countries in southeastern Africa.

BMC Public Health. 2015-8-22

[7]
"What do You Mean I've Got to Wait for Six Weeks?!" Understanding the Sexual Behaviour of Men and Their Female Partners after Voluntary Medical Male Circumcision in the Western Cape.

PLoS One. 2015-7-15

[8]
Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010-11 Zimbabwe demographic and health survey.

Reprod Health. 2015-3-7

[9]
Perceptions and knowledge of voluntary medical male circumcision for HIV prevention in traditionally non-circumcising communities in South Africa.

Glob Public Health. 2015

[10]
Risk factors for HIV infection among circumcised men in Uganda: a case-control study.

J Int AIDS Soc. 2015-1-2

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