Sex is never the same: Men's perspectives on refusing circumcision from an in-depth qualitative study in Kwaluseni, Swaziland
Sex is never the same: Men's perspectives on refusing circumcision from an in-depth qualitative study in Kwaluseni, Swaziland
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DOI：
10.1080/17441692.2015.1004356
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发表时间：
2015-07-03
影响因子：
3.3
通讯作者：
Moyer, Eileen
中科院分区：
文献类型：
--
作者：
Adams, Alfred;Moyer, Eileen
面对18至49岁人群中31%的艾滋病毒流行率，斯威士兰在三个随机对照试验中获得了令人信服的科学证据后，于2009年制定了男性包皮环切术政策。利用美国国际开发署的资金，该州在2011年开始为80%的成年男性进行割礼。在这场运动中，15万名目标男性中只有8667人接受了割礼。本文介绍了2012至2013年间对斯威士兰男性进行的一项深入定性研究的结果。方法包括13次焦点小组讨论、20次深度访谈、16次非正式访谈和参与者观察。我们认为，这场运动的失败可以部分解释为这样一个事实，即割礼被视为对斯威士兰男性气概的威胁，而这一因素在干预计划中几乎没有考虑到。结果显示，男性认为包皮环切术会导致阴茎敏感度降低，性快感降低，不良事件，如手术中可能出现的错误和术后并发症，可能会对他们的性生活产生负面影响。鉴于包皮环切术对性行为或性快感的影响的科学数据相互矛盾的状态，这项研究解决了重要的空白，同时也证明了有必要对性行为、男子气概和寻求让男性参与的健康干预之间的关系进行更多研究。
Faced with an HIV prevalence of 31% among 18- to 49-year-olds, Swaziland developed a male circumcision policy in 2009, following compelling scientific evidence from three randomised controlled trials. Utilising United States Agency for International Development funds, the state set out to circumcise 80% of adult men in 2011. Only 8667 of the targeted 150,000 men were circumcised during the campaign. This paper presents findings from a 2012 to 2013 in-depth qualitative study among Swazi men. Methods included 13 focus group discussions, 20 in-depth interviews, 16 informal interviews and participant observation. We argue that the campaign's failure can be partly explained by the fact that circumcision was perceived as a threat to Swazi masculinities, a factor hardly considered in the planning of the intervention. Results show that men believed circumcision resulted in reduced penis sensitivity, reduced sexual pleasure and adverse events such as possible mistakes during surgery and post-operative complications that could have negative effects on their sexual lives. Given the conflicting state of scientific data about the effects of circumcision on sexuality or sexual pleasure, this study addresses important lacunae, while also demonstrating the need for more research into the relationship between sexuality, masculinity and health interventions seeking to involve men.