Sexual behaviours of medically circumcised men in informal settlements: a case of Luo men in Kibera slums
Odero, Kennedy O
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HIV/AIDS has remained to be a major health challenge over time despite the interventions that have been put in place. The focus on behavior change has recently been advanced to include cultural concerns and as a result male circumcision has been approved as a HIV risk reduction measure and is being scaled up across the country especially in noncircumcising communities and urban settlements. The effectiveness of male circumcision in relation to sexual behavior is a concern for circumcised men including those in informal settlements. Therefore, the broad objective of this research was to assess the sexual behavior of medically circumcised Luo men in Kibera. The specific objectives included the HIV risk sexual behaviours practiced by medically circumcised men, their HIV risk perception, factors that determined their acceptability of male circumcision and also factors that determined their sexual behavior in the slum set up.The study used qualitative research approach as the main data collection method with quantitative method being used to supplement qualitative method. The samples were purposively selected using snowballing technique. The study used various data collection methods such as focus group discussions, key informant interviews and personal interviews. The data collection tools such as focus group interview guide, key informants interview guide and personal interview schedule were used in this study. Qualitative data was analyzed thematically, while quantitative data was analyzed descriptively using Statistical Package for Social Scientist (SPSS). The study found out that majority of the medically circumcised Luo men generally avoided HIV risk sexual behaviours and hence sexual behaviour change and this was mainly due to high HIV risk perception and pre-circumcision counseling. However, some Luo men still practiced risky sexual behaviours after medical male circumcision and this was due to low risk perception following male circumcision. The study also found that Luo men in Kibera considered male circumcision for HIV prevention. In addition, other reasons such as penile hygiene, acceptability by circumcising communities and sexual partners, influence from friends and relatives, sexual enjoyment, and the fact that it is a free procedure were established. The study further found that medically circumcised Luo men considered themselves to be at low risk after medical male circumcision, but majority would still avoid risky sexual behaviours after circumcision because they understood that circumcision does not provide complete protection. The study also established that risky sexual behaviours of circumcised Luo men in Kibera were determined by factors such as peer pressure, entertainment, poverty, being away from family, sexual exposure, alcohol and drug use, risk perception and language use. The study recommended the formation of post-circumcision clubs for promoting safe sexual behaviours. The entertainment points in Kibera need to be regulated and more intervention towards behavior change communication programs in Kibera to be implemented. However, there is need for further study on HIV prevalence of the medically circumcised Luo men group.