Factors Associated with the Early Resumption of Sexual Activity Following Medical Male Circumcision in Nyanza Province, Kenya
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Research has established that voluntary medical male circumcision (VMMC) reduces HIV acquisition in heterosexual men by approximately 60%; however, engaging in sexual activity before the wound is healed may attenuate this protective effect. This prospective study included VMMC clients who were circumcised in Kenya between November, 2008 and March, 2010, aged ≥18 years, and randomly selected for an interview and genital examination 28–45 days post-VMMC (N = 1,344). At the time of the interview, 91.3% participants were healed. Overall, 30.7% reported engaging in early sexual activity, usually 3–4 weeks post-VMMC. In a multivariable analysis, being married or cohabitating was the strongest predictor of engaging in early sexual activity. Strategies to reduce engaging in sexual activity during the recommended 42-day abstinence period following VMMC should be explored including re-energizing the effort to include female partners in counseling, mass education campaigns, and targeted text messaging programs for VMMC clients.
KeywordsHIV Voluntary medical male circumcision Sexual intercourse Wound healing Kenya
Support for this study was provided by a grant to FHI from the Bill & Melinda Gates Foundation to support the Male Circumcision Consortium (MCC), a partnership between FHI, University of Illinois at Chicago working closely with the Nyanza Reproductive Health Society (NRHS), and Engender Health. The views expressed in this publication do not necessarily reflect those of the Bill & Melinda Gates Foundation or the MCC partners. We thank the Government of Kenya and the participants in the study without whom this work would not be possible. We also thank Nixon Otieno, Nelli Westercamp, Deborah Rosenberg, Mark Dworkin, Tim Johnson, Joan Kennelly, the late Jekoniah Ndinya-Achola, and NRHS staff and study research assistants for their commitment to the study and helpful feedback on this manuscript.
- 1.UNAIDS. Voluntary medical male circumcision: global trends and determinants of prevalence, safety, and acceptability. Geneva: World Health Organization; 2007.Google Scholar
- 6.World Health Organization. New data on voluntary medical male circumcision and HIV prevention: policy and programme implications. 2007. http://data.unaids.org/pub/Report/2007/VMMC_recommendations_en.pdf. Accessed 24 March 2011.
- 7.UNAIDS/WHO/SACEMA Expert Group on Modelling the Impact and Cost of Voluntary Medical Male Circumcision for HIV Prevention. Voluntary medical male circumcision for HIV prevention in high HIV prevalence settings: what can mathematical modelling contribute to informed decision making? PLoS Med. 2009;6(9):e1000109. doi: 10.1371/journal.pmed.1000109.
- 12.Kenya National Bureau of Statistics and ICF Macro. Kenya Demographic and Health Survey 2008–09. Calverton: KNBS and ICF Macro. 2010.Google Scholar
- 13.National AIDS and STI Control Programme, Ministry of Health, Kenya. Guidelines for Safe, Voluntary Medical Voluntary medical male circumcision in Kenya. 2008.Google Scholar
- 14.Brachman PS. Surveillance and the primary care physician. J Postgrad Med. 1977;62(2):86–91.Google Scholar
- 17.Lissouba P, Taljaard D, Rech D, et al. A model for the roll-out of comprehensive adult voluntary medical male circumcision services in African low-income settings of high HIV incidence: the ANRS 12126 bophelo pele project. PLoS Med. 2010;7(7):e1000309. doi:10.1371/journal.pmed.1000309.