Abstract
There is insufficient evidence documenting and comparing the prevalence and covariates of human immunodeficiency virus (HIV) risk behaviours among circumcised and uncircumcised men in Botswana. The main aim of this paper was to assess prevalence and covariates of HIV risk behaviours among circumcised and uncircumcised men in Botswana. Data used for this study was derived from the 2013 Botswana AIDS Impact Survey which was a nationally representative, population-based survey. Cross-tabulations and logistic regression analysis were used to assess covariates of HIV risk behaviours among circumcised and uncircumcised men. Mean age for participants in the study was 30.46 years. From a total sample of 3809 men, only 25% were circumcised, 90% had ever heard about safe male circumcision program, 9% were of the view that circumcised men should stop using condoms. Results show that 67% of men were circumcised in government health facility, 16% in private health facility, while 17% in a traditional setting. Logistic regression results show evidence of risk compensation (multiple sex partners) among circumcised men (OR=1.027; 95% CI: 1.002-1.053). On the other hand, circumcised men were less likely to have not used condoms consistently (OR=0.672; 95% CI: 0.531-0.753). Alcohol consumption was found to be a statistically significant covariate of having multiple sex partners (OR=2.101; 95% CI: 2.044-2.161) while in rural residence, Christianity, primary education and the belief that circumcised men should stop using condoms were associated with inconsistent condom use. Further research is needed to understand the complex relationship between men’s circumcision status and HIV risk behaviours in order to design effective interventions. Key words: Determinants, circumcised, un-circumcised, human immunodeficiency virus (HIV) risk behaviour, Botswana.
Highlights
In 2004, the Botswana AIDS Impact Survey II (BAIS II) estimated a national human immunodeficiency virus (HIV)/AIDS prevalence rate of 17.1%, in 2008 BAIS III prevalence rate was estimated at 17.6% (Statistic Botswana, 2009), while in the latest BAIS IV (2013), the national HIV/AIDS prevalence rate was estimated at 18.5% in the general population, and at 15.6% among men (NACA, 2014)
Safe male circumcision in Botswana was introduced as a national response to HIV/AIDS epidemic and it serves to augment existing series of response plans adopted by the government of Botswana over the years
82% of men were reported to be of Christian religion, 12% no religion, while the remaining 6% were from other non-Christian religions
Summary
This came about because Botswana is among the top three countries in subSaharan Africa which have been highly affected by HIV/AIDS epidemic. Some initial studies on safe male circumcision have identified SMC as an effective strategy to reduce HIV infection among hetero sexual men (Bailey, 2002; Largarde et al, 2003; Gray et al, 2007). These initial studies from Kenya, Malawi, Zimbabwe, Swaziland, South Africa, and in Botswana, have indicated that in settings where HIV prevalence is high there are high levels of acceptability of SMC (Nnko et al, 2001; Bailey, 2002; Largarde et al, 2003; Kebaabetswe et al, 2003; Mattson et al, 2005)
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