Factors associated with the early resumption of sexual activity following medical male circumcision in Nyanza province, Kenya

Abstract

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.

Fig. 1

Percent of participants remaining abstinent post-surgery stratified by marital status (n = 1,344)

Fig. 2

Percent of wounds healed 28–42 days after male circumcision (n = 1,198^a). ^aSome participants had an incorrect interview date recorded automatically by the PDA (n = 146); as a result, we were unable to calculate the relationship between lapsed time post-MC and wound healing for them