Spees Lisa P, Wirth Kathleen E, Mawandia Shreshth, Bazghina-Werq Semo, Ledikwe Jenny H
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America.
South Afr J HIV Med. 2020 Dec 14;21(1):1157. doi: 10.4102/sajhivmed.v21i1.1157. eCollection 2020.
Circumcised men may increase sexual risk-taking following voluntary medical male circumcision (VMMC) because of decreased perceptions of risk, which may negate the beneficial impact of VMMC in preventing new human immunodeficiency virus (HIV) infections.
We evaluated changes in sexual behaviour following VMMC.
We conducted a prospective cohort study amongst sexually active, HIV-negative adult men undergoing VMMC in Gaborone, Botswana, during 2013-2015. Risky sexual behaviour, defined as the number of sexual partners in the previous month and ≥ 1 concurrent sexual partnerships during the previous 3 months, was assessed at baseline (prior to VMMC) and 3 months post-VMMC. Change over time was assessed by using inverse probability weighted linear and conditional logistic regression models.
We enrolled 523 men; 509 (97%) provided sexual behaviour information at baseline. At 3 months post-VMMC, 368 (72%) completed the follow-up questionnaire. At baseline, the mean (95% confidence interval) number of sexual partners was 1.60 (1.48, 1.65), and 111 (31% of 353 with data) men reported engaging in concurrent partnerships. At 3 months post-VMMC, 70 (23% of 311 with data) reported fewer partners and 19% had more partners. Amongst 111 men with a concurrent partnership at baseline, 52% reported none post-VMMC. Amongst the 242 (69%) without a concurrent partnership at baseline, 19% reported initiating one post-VMMC. After adjustment for loss to follow-up, risky sexual behaviour post-VMMC (measured as mean changes in a number of partners and proportion engaging in concurrency) was similar to baseline levels.
We found no evidence of sexual risk compensation in the 3 months following VMMC.
接受包皮环切术的男性在自愿医学男性包皮环切术（VMMC）后可能会增加性行为风险，因为他们对风险的认知降低，这可能会抵消VMMC在预防新的人类免疫缺陷病毒（HIV）感染方面的有益影响。
我们评估了VMMC后性行为的变化。
2013年至2015年期间，我们在博茨瓦纳哈博罗内对接受VMMC的性活跃、HIV阴性成年男性进行了一项前瞻性队列研究。危险性行为定义为前一个月的性伴侣数量以及前三个月内≥1个性伴关系，在基线（VMMC前）和VMMC后3个月进行评估。使用逆概率加权线性和条件逻辑回归模型评估随时间的变化。
我们招募了523名男性；509名（97%）在基线时提供了性行为信息。在VMMC后3个月，368名（72%）完成了随访问卷。基线时，性伴侣的平均数量（95%置信区间）为1.60（1.48，1.65），111名男性（有数据的353名中的31%）报告有多个性伴关系。在VMMC后3个月，70名（有数据的311名中的23%）报告性伴侣减少，19%的人性伴侣增多。在基线时有多个性伴关系的111名男性中，52%在VMMC后报告没有多个性伴关系。在基线时没有多个性伴关系的242名男性（69%）中，19%在VMMC后报告开始有多个性伴关系。在对失访进行调整后，VMMC后的危险性行为（以性伴侣数量和多个性伴关系比例的平均变化衡量）与基线水平相似。
我们没有发现VMMC后3个月内存在性风险补偿的证据。
