Male Circumcision; willingness to undergo safe male circumcision and HIV risk among men in Botswana

This paper uses data from the 2008 Botswana AIDS Impact Survey to explore the association between male circumcision or willingness to undergo safe male circumcision; and men's sexual and HIV risk behaviours in Botswana. Bivariate and multivariate regression analysis techniques are used. The results show that being circumcised; or expressing willingness to be circumcised; was associated with significant increase in the likelihood of having two or more current sexual partners; and having had sex with multiple partners during the year leading to the survey; even after controlling for confounding variables. There is a need for further research to examine the association between male circumcision and men's sexual practices in Botswana. Such context specific research will provide the necessary evidence base for HIV prevention and impact mitigation programs; interventions and strategies and to provide rigorous estimates of the extent men's sexual risk compensation and 'sexual disinhibition' associated with the reduced risk of HIV infection accorded by safe male circumcision. Current efforts to promote male circumcision as an integral part of the country's HIV prevention and control strategy need to be accompanied by continuous education to address myths and misconceptions relating to safe male circumcision

HIV counselling and testing of pregnant women attending antenatal clinics in Botswana, 2001.

This study examined the extent to which women accessing antenatal-care services in Botswana were offered HIV-related information and counselling and an opportunity to take an HIV test as part of the Prevention of Mother-to-Child Transmission of infection, and how these women responded. Data for this study were drawn from the Botswana AIDS Impact Survey 2001, a nationally-representative sample survey. The survey successfully interviewed over 4,494 of 4,728 eligible women on various issues relating to HIV/AIDS at both household and individual levels. Frequencies, cross tabulations, and logistic regression were used for data analysis. Over half (57.9%) of the women were offered HIV/AIDS-related information, counselling, or testing. Age, education, and residence were important predictors of being offered HIV counselling or testing. Younger and more-educated women and those residing in towns were more likely to be offered both HIV counselling and testing than older, less-educated, and rural women. Seventy-nine percent of the women who were offered HIV testing agreed to undergo the test regardless of their background characteristics. The number of pregnant women who underwent HIV testing during antenatal care accounted for only a fifth (21%) of all antenatal-care attendees in 2001. Lack of capacity to deliver voluntary counselling and testing services to all pregnant women attending antenatal care is one of the biggest challenges to increased use of voluntary counselling and testing services.

Factors associated with non-use of maternal health services in Botswana.

The study investigated individual and household factors associated with non-use of maternal health services in Botswana. Nationally-representative data, drawn from the 1996 Botswana Family Health Survey, were used. A weighted sample of 19,031 women, aged 15-49 years, who had at least one pregnancy history in the five years prior to the survey was considered for analysis. Both simple cross-tabulations and logistic regression were used for analyzing the data. Consistently, the teenagers were less likely to seek prenatal care, to have their babies delivered by a qualified person, and to seek postnatal check-up. Using results from logistic regression analysis, it can be observed that low-parity women were less likely to use maternal services. Another consistent finding is that women with low educational level, those residing in rural areas, and those with low socioeconomic status were less likely to use maternal services. More focussed investigation is needed, but understanding the differentials of the use of maternal services allows policy-makers to identify problem areas that need attention.