Pintye Jillian C, Wirth Kathleen E, Ntsuape Conrad, Kleinman Nora J, Spees Lisa, Semo Bazghina-Werq, Mawandia Shreshth, Ledikwe Jenny
Department of Global Health, University of Washington, Seattle, United States.
Botswana International Training and Education Center for Health (I-TECH), Gaborone, Botswana.
South Afr J HIV Med. 2020 Apr 20;21(1):1042. doi: 10.4102/sajhivmed.v21i1.1042. eCollection 2020.
Uptake of voluntary medical male circumcision (VMMC) remains modest in Botswana in spite of the government's commitment and service provision availability. Data on sexual function post-VMMC in programmatic settings could help guide messaging tailored to Botswana.
At 3-month post-VMMC, we evaluated changes in sexual function and satisfaction with the VMMC procedure amongst a cohort of HIV-negative, sexually active men aged 18-49 years who underwent VMMC in a public-sector clinic in Botswana.
We assessed whether each of the following domains of sexual function had improved, stayed the same or worsened since VMMC: sexual desire, ability to use condoms, ease of vaginal penetration, ease of ejaculation, ability to achieve and maintain an erection and hygiene or cleanliness.
Data on sexual function were available for 378 men at 3-month post-VMMC. Median age was 27 years - 54% had a higher than secondary education, 72% were employed and 27% were married. Nearly all (96%) the men reported improvement in at least one domain of sexual function, while 19% reported improvement in all six domains. One-fourth (91/378, 24%) of the men reported that at least one domain of sexual function worsened post-VMMC. The most frequently reported domain that worsened was sexual desire (11%); in all other domains, < 10% of the men reported worsening. Men who reported any worsening sexual function were 2.3-fold as likely to be less than 'very satisfied' with the VMMC procedure (risk ratio 2.36, 95% confidence interval [CI] 1.66-3.34, < 0.001).
Emphasising improved sexual function experienced after VMMC in demand-creation efforts could potentially increase VMMC uptake in Botswana.
尽管博茨瓦纳政府做出了承诺且提供了相关服务，但自愿男性包皮环切术（VMMC）的接受率仍然不高。在项目实施环境中，关于VMMC后性功能的数据有助于指导针对博茨瓦纳的宣传信息。
在VMMC后3个月，我们评估了一群年龄在18 - 49岁、HIV阴性、性活跃且在博茨瓦纳一家公共部门诊所接受VMMC的男性的性功能变化以及对VMMC手术的满意度。
我们评估了自VMMC以来性功能的以下各个方面是有所改善、保持不变还是恶化：性欲、使用避孕套的能力、阴道插入的难易程度、射精的难易程度、勃起和维持勃起的能力以及卫生或清洁情况。
在VMMC后3个月，有378名男性的性功能数据可用。中位年龄为27岁，54%的人受过高中以上教育，72%的人有工作，27%的人已婚。几乎所有（96%）男性报告至少有一个性功能方面有所改善，而19%的人报告所有六个方面都有所改善。四分之一（91/378，24%）的男性报告至少有一个性功能方面在VMMC后恶化。最常报告恶化的方面是性欲（11%）；在所有其他方面，报告恶化的男性不到10%。报告性功能有任何恶化的男性对VMMC手术“非常满意”的可能性要低2.3倍（风险比2.36，95%置信区间[CI] 1.66 - 3.34，<0.001）。
在促进需求的努力中强调VMMC后性功能的改善可能会提高博茨瓦纳VMMC的接受率。
