Page 146 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 8 Original Research

Sexual function after voluntary medical male

circumcision for human immunodeficiency

virus prevention: Results from a programmatic

delivery setting in Botswana

Authors: Background: Uptake of voluntary medical male circumcision (VMMC) remains modest in
Jillian C. Pintye 1 Botswana in spite of the government’s commitment and service provision availability. Data
Kathleen E. Wirth
2,3
Conrad Ntsuape 4 on sexual function post-VMMC in programmatic settings could help guide messaging tailored
Nora J. Kleinman 1,2,5,6 to Botswana.
Lisa Spees 7,8
Bazghina-werq Semo 1,2,9 Objectives: At 3-month post-VMMC, we evaluated changes in sexual function and satisfaction
Shreshth Mawandia 1,2 with the VMMC procedure amongst a cohort of HIV-negative, sexually active men aged 18–49
Jenny Ledikwe 1,2 years who underwent VMMC in a public-sector clinic in Botswana.
Affiliations: Methods: We assessed whether each of the following domains of sexual function had
1 Department of Global Health, improved, stayed the same or worsened since VMMC: sexual desire, ability to use condoms,
University of Washington,
Seattle, United States ease of vaginal penetration, ease of ejaculation, ability to achieve and maintain an erection and
hygiene or cleanliness.
2 Botswana International
Training and Education Results: Data on sexual function were available for 378 men at 3-month post-VMMC. Median
Center for Health (I-TECH), age was 27 years – 54% had a higher than secondary education, 72% were employed and 27%
Gaborone, Botswana 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,
3 Department of Biostatistics, 24%) of the men reported that at least one domain of sexual function worsened post-VMMC.
Harvard T.H. Chan School of
Public Health, Boston, The most frequently reported domain that worsened was sexual desire (11%); in all other
Massachusetts, United States 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
4 Department of HIV/AIDS (risk ratio 2.36, 95% confidence interval [CI] 1.66–3.34, p < 0.001).
Prevention and Care,
Botswana Ministry of Conclusion: Emphasising improved sexual function experienced after VMMC in demand-
Health and Wellness, creation efforts could potentially increase VMMC uptake in Botswana.
Gaborone, Botswana
Keywords: Botswana; voluntary medical male circumcision; human immunodeficiency virus
5 NJK Consulting, Seattle, (HIV) prevention; men; implementation science; program delivery.
Washington, United States
6 Amgen Asia Holdings Ltd, Introduction
Hong Kong, Japan
Continued promotion of voluntary medical male circumcision (VMMC) programmes in countries
7 Department of Health Policy
and Management, University with high human immunodeficiency virus (HIV) burden and low male circumcision rates is
1,2,3
of North Carolina, Chapel Hill, needed to decrease population-level HIV incidences. More than 18.6 million men have been
United States, circumcised through VMMC programmes in 14 priority African countries to date, averting an
estimated 230,000 new HIV infections by 2017. 4,5,6,7,8 Achieving the global target of 27 million more
8 Lineberger Comprehensive VMMC procedures by 2021, translating to 90% of males aged 10–29 years being circumcised in
Cancer Center, University of priority countries, will depend in part on the continued acceptability of VMMC amongst target
North Carolina, Chapel Hill,
3
9
United States populations. Uptake of VMMC began slowly in Botswana and has remained modest
in spite of government commitment, donor support and availability of service provision of
9 FHI 360, Washington, VMMC since 2009. In 2018, Botswana achieved less than 50% of the country’s target of 25 000
Washington, United States VMMC procedures. 10
Project Research Number: IRB# 42047 | HRDC# 00699
Read online: Corresponding author: Jillian Pintye, [email protected]
Read online:
Scan this QR
Scan this QR Dates: Received: 01 Nov. 2019 | Accepted: 28 Nov. 2019 | Published: 20 Apr. 2020
code with your
code with your
smart phone or
smart phone or How to cite this article: Pintye JC, Wirth KE, Ntsuape C, et al. Sexual function after voluntary medical male circumcision for human
mobile device immunodeficiency virus prevention: Results from a programmatic delivery setting in Botswana. S Afr J HIV Med. 2020;21(1), a1042.
mobile device
to read online. https://doi.org/10.4102/sajhivmed.v21i1.1042
to read online.
Copyright: © 2020. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
http://www.sajhivmed.org.za 138 Open Access