Department of Population Studies, University of Botswana, Gaborone, Botswana.
AIDS Care. 2020 Dec;32(12):1594-1601. doi: 10.1080/09540121.2020.1769830. Epub 2020 May 23.
HIV/AIDS prevalence is still high in Botswana. The main aim of this study was to assess and compare sexual risk behaviours of circumcised and uncircumcised men before and after the launch of the safe male circumcision programme. Data used for analyses were derived from the 2008 and 2013 Botswana AIDS Impact Surveys. Modified Poisson regression analysis was used to obtain prevalence ratios (PR) as measures of association between circumcision status and multiple sexual partners, transactional sex, inconsistent condom use and intergenerational sex. The proportion of circumcised men increased two times between 2008 (12.5%) and 2013 (25.2%). Prevalence of multiple sexual partnerships was high among uncircumcised than circumcised (54.6% vs. 46.4%) men in 2008, but in 2013 after the introduction of the SMC programme it was slightly high among circumcised men than uncircumcised men (23.2 vs. 21.8%). In the adjusted analyses, being circumcised was significantly associated with having multiple sexual partners (2008=adjusted PR=1.31, CI=1.10-1.57; 2013= adjusted PR=1.12, CI=1.01-1.41) and transactional sex (2008=adjusted PR=1.98, CI=1.26-3.11; 2013=adjusted PR=1.60, CI=1.09-1.22) for both survey periods. These results indicate the need to continuously sensitise and encourage men to stop multiple sexual partnerships and transactional sex. Moreover, there is need to encourage all men to use condoms consistently.
博茨瓦纳的艾滋病毒/艾滋病流行率仍然很高。本研究的主要目的是评估和比较安全男性割礼计划推出前后,已割礼和未割礼男性的性风险行为。用于分析的数据来自 2008 年和 2013 年博茨瓦纳艾滋病影响调查。使用修正泊松回归分析获得流行比率(PR)作为割礼状况与多个性伴侣、交易性行为、不坚持使用安全套和代际性行为之间关联的度量。2008 年(12.5%)和 2013 年(25.2%)之间,已割礼男性的比例增加了两倍。2008 年,未割礼男性的多个性伴侣比割礼男性高(54.6%对 46.4%),但在 2013 年,在引入 SMC 计划后,割礼男性的比例略高于未割礼男性(23.2%对 21.8%)。在调整分析中,割礼与多个性伴侣(2008 年=调整后的 PR=1.31,CI=1.10-1.57;2013 年=调整后的 PR=1.12,CI=1.01-1.41)和交易性行为(2008 年=调整后的 PR=1.98,CI=1.26-3.11;2013 年=调整后的 PR=1.60,CI=1.09-1.22)之间存在显著关联,两个调查期都是如此。这些结果表明,需要不断提高男性对停止多个性伴侣和交易性行为的认识,并鼓励他们这样做。此外,还需要鼓励所有男性坚持使用安全套。