Abstract
This article examines perceptions of sexual functioning, satisfaction, and risk-taking related to voluntary medical male circumcision (VMMC) in Botswana. Twenty-seven focus group discussions were conducted in four purposively selected communities with community leaders, men, and women. Discussions were analyzed using an inductive content analytic approach. Perceptions of VMMC’s impact on sexual functioning and satisfaction varied. Increased satisfaction was attributed to improved penile health and increased ejaculatory latency time, whereas decreased satisfaction was attributed to erectile dysfunction and increased vaginal irritation during sex. Most participants thought sexual disinhibition occurred after circumcision; nevertheless, some women said they used male circumcision status as a marker of HIV status, thereby influencing sexual decision-making and partner selection. Messaging should emphasize that VMMC does not afford complete HIV protection. Optimizing VMMC’s impact requires increasing uptake while minimizing behavioral disinhibition, with a balance between potential messaging of improved sexual functioning and satisfaction and the potential impact on sexual disinhibition.
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Acknowledgments
The authors would like to gratefully acknowledge Boyce Otlhomile, Maggie Nkgau, and Spencer Manthe for their assistance in recruitment of study participants and transcription of audio recordings and the participants who gave generously of their time. This work was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR), through grant number U91HA06801 from the US Department of Health and Human Services, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau’s Global Health Systems Branch. Its contents are solely the responsibility of the authors and do not represent the official views of the US government.
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Ledikwe, J.H., Mawandia, S., Kleinman, N.J. et al. Voluntary Medical Male Circumcision and Perceived Sexual Functioning, Satisfaction, and Risk Behavior: A Qualitative Study in Botswana. Arch Sex Behav 49, 983–998 (2020). https://doi.org/10.1007/s10508-019-01589-7
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DOI: https://doi.org/10.1007/s10508-019-01589-7