title: Male circumcision, alcohol use and unprotected sex among patrons of bars and taverns in rural areas of North-West province, South Africa.
abstract: Strong research evidence has shown that medical male circumcision significantly reduces heterosexual HIV acquisition among men. However, its effectiveness is enhanced by behavioural factors such as condom use. Currently, little is known of unprotected sex associated with male circumcision (MC) among alcohol-drinking tavern-going men, or whether engagement in unprotected sex may differ between men who have been traditionally circumcised and those who have been medically circumcised. The study sought to determine the relative importance of alcohol consumption and MC as correlates of unprotected sex and to compare the risk of engaging in unprotected sex between traditionally circumcised and medically circumcised tavern-going men from two rural villages in North-West province, South Africa. Data from 314 adult men (≥18 years) were analysed. The men were recruited from four bars/taverns using systematic sampling. They responded to questions regarding their demographic characteristics, alcohol consumption, circumcision status and method (where applicable), and engagement in unprotected sex. Descriptive analyses and bivariate and multivariate logistic regression analyses were conducted. Age, education, relationship status, alcohol consumption and traditional male circumcision (TMC) were independently and significantly associated with unprotected sex. Specifically, probable alcohol dependence and traditional circumcision were independent risk factors for engaging in unprotected sex among tavern-going men. Traditionally circumcised men had a higher risk of engaging in unprotected sex than medically circumcised men. Interventions aimed at reducing alcohol consumption, encouraging protective behaviour among men who have undergone TMC, and increasing condom use are needed in bar/tavern settings. HIV prevention education must be urgently incorporated into TMC programmes.
authors.affiliation: a Alcohol, Tobacco, & Other Drug Research Unit , Medical Research Council , Pretoria , South Africa.
authors.forename: Sebenzile
authors.initials: S
authors.lastname: Nkosi
authors.forename: Yandisa
authors.initials: Y
authors.lastname: Sikweyiya
authors.forename: Connie T
authors.initials: CT
authors.lastname: Kekwaletswe
authors.forename: Neo K
authors.initials: NK
authors.lastname: Morojele
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D000435:Alcoholic Intoxication; D002944:Circumcision, Male; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control*; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population; D013019:South Africa; D047568:Unsafe Sex; D055815:Young Adult
keywords: South Africa; alcohol; bar patrons; medical male circumcision; traditional male circumcision; unprotected sex