United Nations Population Fund, Abuja, Nigeria.
Osun State University, Osogbo, Osun State, Nigeria.
Reprod Health. 2022 Apr 7;19(1):91. doi: 10.1186/s12978-022-01379-w.
Female Genital Mutilation (FGM) is believed to have a negative effect on sexual and reproductive health but the evidence from nationally representative sample in high-burdened countries like Nigeria is scarce. This study explored the association between FGM and sexual behaviour in a nationally representative sample of Nigerian women.
A secondary data analysis was conducted using the Nigeria Demographic Health Survey conducted in 2013 and 2018 among women aged 15-49 years. The descriptive summaries of respondent characteristics by marital status were presented using frequencies and percentages. The proportion and 95% Confidence Interval (CI) of circumcision by sexual behaviour characteristics were computed. A multivariable log-binomial logistic regression was used to determine the association between sexual behaviour and female circumcision while adjusting for other covariates. All analyses were performed using Stata 15.1 (StataCorp, College Station, TX, USA) at the 0.05 level of significance.
The proportion of circumcised women was 38.6% among those who were ever-married and 32.4% among those unmarried. There were no statistically significant relationship between circumcision status and sexual behaviour among women who were unmarried. However, circumcised women who were ever married had 18% higher risk of having contracted sexually transmitted disease in the last 12 months preceeding the survey and 10% higher risk of engaging in pre-marital sex compared to ever married women who were uncircumcised after adjusting for other covariates. However, the risk of having multiple sexual partners in the last 12 month among uncircumcised ever married women was lower (aRR = 0.80; 95% CI: 0.66-0.97) in the adjusted model.
Circumcision is not associated with positive sexual behavioural outcomes including delay in sexual debut, virginity and marital fidelity, although there exists some perception behind increasing FGM in Nigeria including prevention of premarital sex and ensuring marital fidelity. While we strongly discourage FGM in all its form, we assert the need for alternative health promoting community measures to address these inherent sexual perceptions toward eliminating FGM and improving sexual and reproductive health across population groups.
女性割礼被认为会对性健康和生殖健康产生负面影响，但在像尼日利亚这样的高负担国家，来自全国代表性样本的证据很少。本研究探讨了在尼日利亚全国代表性妇女样本中，女性割礼与性行为之间的关联。
使用 2013 年和 2018 年在 15-49 岁女性中进行的尼日利亚人口与健康调查进行二次数据分析。按婚姻状况对受访者特征的描述性摘要用频率和百分比表示。根据性行为特征计算了割礼的比例和 95%置信区间 (CI)。使用多变量对数二项式逻辑回归来确定性行为与女性割礼之间的关联，同时调整其他协变量。所有分析均使用 Stata 15.1（StataCorp，College Station，TX，USA）在 0.05 水平上进行。
在已婚女性中，割礼女性的比例为 38.6%，在未婚女性中为 32.4%。在未婚女性中，割礼状况与性行为之间没有统计学上的显著关系。然而，已婚且割礼的女性在调查前的过去 12 个月内感染性传播疾病的风险增加了 18%，与未割礼的已婚女性相比，婚前性行为的风险增加了 10%，而在调整了其他协变量后。然而，在调整后的模型中，在过去 12 个月内，未割礼的已婚女性中拥有多个性伴侣的风险较低（ARR=0.80；95%CI：0.66-0.97）。
割礼与包括延迟性初潮、贞操和婚姻忠诚在内的积极性行为结果无关，尽管在尼日利亚存在一些增加女性割礼的观念，包括预防婚前性行为和确保婚姻忠诚。虽然我们强烈反对所有形式的女性割礼，但我们坚持认为需要采取替代的促进健康的社区措施，以消除这些固有的对性行为的看法，从而改善整个人群的性健康和生殖健康。
