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Factors Associated with the Early Resumption of Sexual Activity Following Medical Male Circumcision in Nyanza Province, Kenya

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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.

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Acknowledgments

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.

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Correspondence to Amy Herman-Roloff.

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Herman-Roloff, A., Bailey, R.C. & Agot, K. Factors Associated with the Early Resumption of Sexual Activity Following Medical Male Circumcision in Nyanza Province, Kenya. AIDS Behav 16, 1173–1181 (2012). https://doi.org/10.1007/s10461-011-0073-1

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