Better or worse? Women, sex and male circumcision

2009-07-24 00:00

NERVOUS giggles filled a meeting room at the fifth International Aids Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009) recently, when discussions turned to the sexual satisfaction of the female partners of circumcised men and the “cosmetic outcome” of the circumcision.

“How did you measure the sexual satisfaction of the woman partner?” a delegate from Zimbabwe asked, while a delegate from Botswana quizzed the researcher on whether they had reports from those who think the “circumcised penis looks ugly, it’s awful”.

Three research studies have shown unequivocally that male circumcision leads to a 50% to 60% reduction in the transmission of HIV to the male partner. It has shown no protective benefit to the woman partner.

Godfrey Kigozi of the Rakai Health Sciences Programme in Uganda described how they had recorded the sexual satisfaction of 455 women between the ages of 15 and 49 who were partners of men who had been circumcised as part of the initial trials to test the efficacy of male circumcision.

Researchers collected information from the women before their partners were circumcised and after, with the women self-reporting the changes in sexual pleasure. Around 57% of the women reported no change in sexual pleasure, while 39% reported an improvement. A total of three percent reported less satisfaction.

Kigozi said they quizzed the women on why their sexual satisfaction was less and they blamed it on the fact that the man’s sexual desire had decreased and that their partner was struggling to achieve an erection.

The vast majority who reported improved sexual satisfaction placed improved hygiene and the fact that their partner took longer to achieve an orgasm, resulting in longer sex, top of their list.

On a more serious note, Tim Lane of the University of California San Francisco reported on observational data from the Soweto Men’s Study which was showing that there was a lower risk of HIV infection among circumcised men who have sex with men (MSM).

Early indications are that the odds of infection among uncircumcised MSM reporting insertive anal intercourse with male partners was four- and-half times higher than among insertive circumcised MSM.

A staggering 40% of the men studied reported also having sex with women. Lane said it was important to consider a randomised controlled trial of circumcision among MSM.

Deputy director general for Strategic Health Programmes in the South African Health Department Dr Yogan Pillay said he is interested in learning about experiences from other countries as “we are in the process of finalising a policy around male circumcision”. — Health-e News

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