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Journal articles on the topic 'Circumcision – Health aspects – Botswana'

Author: Grafiati

Published: 4 June 2021

Last updated: 2 February 2022

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1

LANGENI, TABITHA. "MALE CIRCUMCISION AND SEXUALLY TRANSMITTED INFECTIONS IN BOTSWANA." Journal of Biosocial Science 37, no. 1 (2004): 75–88. http://dx.doi.org/10.1017/s0021932003006400.

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This study set out to investigate the influence of male circumcision and other factors on sexually transmitted infections in Botswana. A syndromic approach, which diagnoses a sexually transmitted infection based on the presence of urethral discharge or genital ulcers rather than on laboratory tests, was used. The data were from the 2001 Botswana AIDS Impact Survey where a nationally representative, randomly selected sample of men and women aged 10–64 years were interviewed in both urban and rural areas. The sample selected for this study consisted of 216,480 men aged 15–64 years who had ever had sexual intercourse. The logistic regression technique was executed to examine the association between male circumcision and self-reported urethral discharge or genital ulcers, while controlling for all other independent variables in the analysis. The main finding of this study was that among men who are circumcised, the odds for self-reported urethral discharge or genital ulcers are significantly lower than for those men who are not circumcised in both urban and rural Botswana. The analysis also showed that the odds in favour of self-reported urethral discharge or genital ulcers, for men who drink alcohol, are twice as large as those for men who do not drink alcohol, controlling for all other independent variables in the analysis. Religion and ethnicity also came through as factors exerting a protective influence against self-reported symptoms of sexually transmitted infections. The conclusion is that while male circumcision appears to be significantly associated with the risk for self-reported urethral discharge or genital ulcers, it is man’s behaviour, irrespective of ethnicity or religious dictates, that continues to play a vital role in protection against self-reported symptoms of sexually transmitted infections in Botswana.

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2

Sabone, Motshedisi, Mabel Magowe, Lesego Busang, Jonathan Moalosi, Benjamin Binagwa, and Janet Mwambona. "Impediments for the Uptake of the Botswana Government's Male Circumcision Initiative for HIV Prevention." Scientific World Journal 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/387508.

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Botswana remains one of the countries with high prevalence of HIV infection with a population prevalence rate of 17.6 in 2008. In 2009, the Ministry of Health launched male circumcision as an additional strategy to the already existing HIV preventive efforts. The purpose of this paper is to share what the participants of a survey to evaluate a short-term male circumcision communication strategy in seven health districts of Botswana reported as impediments for the program's uptake. Qualitative data were obtained from 32 key informants and 36 focus group discussions in 2011. Content analysis method was used to analyze data and to derive themes and subthemes. Although male circumcision was generally acceptable to communities in Botswana, the uptake of the program was slow, and participants attributed that to a number of challenges or impediments that were frustrating the initiative. The impediments were organized into sociocultural factors, knowledge/informational factors, and infrastructural and system factors.

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3

Spees, Lisa P., Jenny H. Ledikwe, Nora J. Kleinman, et al. "Immediate Motivators to Seeking Voluntary Medical Male Circumcision Among HIV-Negative Adult Men in an Urban Setting in Botswana." AIDS Education and Prevention 31, no. 2 (2019): 136–51. http://dx.doi.org/10.1521/aeap.2019.31.2.136.

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Randomized trials have shown that voluntary medical male circumcision (VMMC) significantly reduces HIV acquisition risk in men. We sought to identify subpopulations of Botswanan men with high levels of VMMC uptake by comparing an observational cohort of men presenting for circumcision services at two high-volume clinics in Botswana's capital city, Gabo-rone, with a matched, population-based random sample of uncircumcised men. Among these high uptake VMMC subpopulations, we then examined the immediate factors that play a role in men's decision to seek VMMC services. As compared to their population-based controls, men choosing to undergo circumcision were more likely to be ages 24–34, more highly educated, to have a religious affiliation, and in a serious relationship. Our results suggest that married men and highly educated men were more likely to pursue circumcision for personal hygiene reasons. These findings have direct implications for targeted demand creation and mobilization activities to increase VMMC uptake in Botswana.

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4

Jayeoba, Oluwemimo, Scott Dryden-Peterson, Lillian Okui, et al. "Acceptability of Male Circumcision Among Adolescent Boys and their Parents, Botswana." AIDS and Behavior 16, no. 2 (2011): 340–49. http://dx.doi.org/10.1007/s10461-011-9929-7.

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5

Bollinger, Lori A., John Stover, Godfrey Musuka, Boga Fidzani, Themba Moeti, and Lesego Busang. "The cost and impact of male circumcision on HIV/AIDS in Botswana." Journal of the International AIDS Society 12, no. 1 (2009): 7. http://dx.doi.org/10.1186/1758-2652-12-7.

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6

Earp, Brian D., and Robert Darby. "Circumcision, Autonomy and Public Health." Public Health Ethics 12, no. 1 (2017): 64–81. http://dx.doi.org/10.1093/phe/phx024.

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7

Radková, Libuša, Radovan Boča, and Ladislav Šoltés. "Ethical and health aspects of the circumcision in women." Kontakt 7, no. 1-2 (2005): 160–63. http://dx.doi.org/10.32725/kont.2005.032.

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8

., Omo Ohiokpehai. "Nutritional Aspects of Street Foods in Botswana." Pakistan Journal of Nutrition 2, no. 2 (2003): 76–81. http://dx.doi.org/10.3923/pjn.2003.76.81.

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9

Kessel, Ross, Frank Miller, Ruth Macklin, Robert A. Rubinstein, and Sandra D. Lane. "Circumcision Revisited." Hastings Center Report 27, no. 2 (1997): 4. http://dx.doi.org/10.2307/3527618.

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10

Semo, Bazghina-Werq, Kathleen Wirth, Conrad Ntsuape, et al. "Modifying the health system to maximize voluntary medical male circumcision uptake: a qualitative study in Botswana." HIV/AIDS - Research and Palliative Care Volume 10 (December 2017): 1–8. http://dx.doi.org/10.2147/hiv.s144407.

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11

van Heteren, Godelieve. "Circumcision and circumvention: female circumcision and social–moral dissensus in pluralistic environments." Health Care Analysis 6, no. 2 (1998): 163–66. http://dx.doi.org/10.1002/(sici)1099-1042(199806)6:2<163::aid-hca1271>3.0.co;2-x.

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12

Batzer, Frances R., and Joshua M. Hurwitz. "Male Neonatal Circumcision: Ritual or Public-Health Imperative." American Journal of Bioethics 3, no. 2 (2003): 26–27. http://dx.doi.org/10.1162/152651603766436388.

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13

Hampton, Wayne F. "Nontherapeutic Circumcision Is Ethically Bankrupt." American Journal of Bioethics 3, no. 2 (2003): 21–22. http://dx.doi.org/10.1162/152651603766436360.

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14

Hutson, J. M. "Circumcision: a surgeon's perspective." Journal of Medical Ethics 30, no. 3 (2004): 238–40. http://dx.doi.org/10.1136/jme.2002.001313.

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15

Misra, Supriya, Haitisha T. Mehta, Evan L. Eschliman, et al. "Identifying “What Matters Most” to Men in Botswana to Promote Resistance to HIV-Related Stigma." Qualitative Health Research 31, no. 9 (2021): 1680–96. http://dx.doi.org/10.1177/10497323211001361.

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Despite a comprehensive national program of free HIV services, men living with HIV in Botswana participate at lower rates and have worse outcomes than women. Directed content analysis of five focus groups ( n = 38) and 50 in-depth interviews with men and women with known and unknown HIV status in Gaborone, Botswana in 2017 used the “what matters most” (WMM) and “structural vulnerability” frameworks to examine how the most valued cultural aspects of manhood interact with HIV-related stigma. WMM for manhood in Botswana included fulfilling male responsibilities by being a capable provider and maintaining social status. Being identified with HIV threatened WMM, which fear of employment discrimination could further exacerbate. Our findings indicate how cultural and structural forces interact to worsen or mitigate HIV-related stigma for urban men in Botswana. These threats to manhood deter HIV testing and treatment, but interventions could capitalize on cultural capabilities for manhood to promote stigma resistance.

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16

Ciesielski-Carlucci, Chris, Nancy Milliken, and Neal H. Cohen. "Determinants of Decision Making for Circumcision." Cambridge Quarterly of Healthcare Ethics 5, no. 2 (1996): 228–36. http://dx.doi.org/10.1017/s0963180100006976.

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Research is ongoing concerning the medical risks and benefits of routine neonatal male circumcision. Interpretation of the data, however, is controversial. Circumcision presents a number of challenges in obtaining informed consent because of a variety of interesting issues. It is a nonemergent, elective procedure that allows for evaluation and discussion over time. In this respect, observation of the informed consent process for circumcision is relevant to other medical decisions, such as advance directives, discussed between primary care providers and patients. Obtaining informed consent for circumcision has its constraints. The process generally occurs over a brief hospital stay. There have been recent changes in the official position regarding the procedure by professional medical societies, and it raises considerable psychologic issues for the provider and may Impact the way in which Information is provided.

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17

Svoboda, J. Steven, Peter W. Adler, and Robert S. Van Howe. "Circumcision Is Unethical and Unlawful." Journal of Law, Medicine & Ethics 44, no. 2 (2016): 263–82. http://dx.doi.org/10.1177/1073110516654120.

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The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision—the removal of this structure—is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons. Early claims about its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.Circumcision violates the cardinal principles of medical ethics, to respect autonomy (self-determination), to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent.In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys› absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision.

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18

Grande, Nuno R. "Female circumcision in Nigeria—A note." Health Care Analysis 6, no. 1 (1998): 30–31. http://dx.doi.org/10.1007/bf02678075.

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19

Wall, Andrew. "Female circumcision in Nigeria—Simply unethical?" Health Care Analysis 6, no. 1 (1998): 31–33. http://dx.doi.org/10.1007/bf02678076.

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20

Erwin, Deborah O., and Chris Hackler. "Female circumcision: A cross-cultural conundrum." Health Care Analysis 6, no. 1 (1998): 35–39. http://dx.doi.org/10.1007/bf02678078.

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21

Mavundla, Thandisizwe R., Fungai Mbengo, and Khanyenda Bruce Ngomi. "Perceived influence of value systems on the uptake of voluntary medical male circumcision among men in Kweneng East, Botswana." SAHARA-J: Journal of Social Aspects of HIV/AIDS 17, no. 1 (2020): 22–29. http://dx.doi.org/10.1080/17290376.2020.1810748.

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22

Brady, Michael T. "Newborn Male Circumcision with Parental Consent, as Stated in the AAP Circumcision Policy Statement, Is Both Legal and Ethical." Journal of Law, Medicine & Ethics 44, no. 2 (2016): 256–62. http://dx.doi.org/10.1177/1073110516654119.

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Newborn male circumcision is a minor surgical procedure that has generated significant controversy. Accumulating evidence supports significant health benefits, most notably reductions in urinary tract infections, acquisition of HIV and a number of other sexually transmitted infections, penile cancer, phimosis, paraphimosis, balanitis and lichen sclerosis. While circumcision, like any surgical procedure, has risks for complications, they occur in less than 1 in 500 infants circumcised and most are minor and require minimal intervention. The CDC and the American Academy of Pediatrics (AAP) believe that health benefits of circumcision outweigh the risks. For this reason, the AAP believes that parents should be allowed to make the decision concerning circumcision of their male infants after receiving non-biased information on health risks and health benefits.

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23

Pintye, Jillian, Kathleen E. Wirth, Conrad Ntsuape, et al. "Early resumption of sex after voluntary medical male circumcision for HIV prevention within a programmatic delivery setting in Botswana." International Journal of STD & AIDS 30, no. 13 (2019): 1275–83. http://dx.doi.org/10.1177/0956462419866051.

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To maximize the public health benefits of voluntary medical male circumcision (VMMC) in real-world settings, sexual abstinence is recommended for six weeks following VMMC to ensure complete wound healing. We determined the frequency and predictors of early resumption of sex among a cohort of HIV-negative, sexually active men 18–49 years who underwent VMMC within a public-sector clinic in Botswana. Multivariate robust Poisson regression methods were used to identify predictors of having any sexual intercourse in the last six weeks since undergoing VMMC. In total, 433/519 (83%) men had data available on sexual activity at six weeks post-VMMC. Median age was 27 years, 57% had a higher than secondary education, 72% were employed, and 9% were married. Overall, 122/433 (28%) men had sexual intercourse within the six weeks since VMMC, of whom 36% reported inconsistent condom use. Compared to men ≥34 years, men aged <30 years (adjusted risk ratio [aRR] = 1.71, 95% CI 0.95–3.08) and men 30–34 years had a two-fold higher likelihood of resuming sexual activity early in multivariate analyses (aRR = 2.31, 95% CI 1.26–4.25, Wald p = 0.018). Employed men were more likely to resume sexual activity early than unemployed men (aRR = 1.58, 95% CI 1.02–2.44, p = 0.039). Additional interventions are needed to encourage abstinence until complete wound healing.

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24

Lyons, B. "Male Infant Circumcision as a 'HIV Vaccine'." Public Health Ethics 6, no. 1 (2013): 90–103. http://dx.doi.org/10.1093/phe/phs039.

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25

Opondo, Philip R., Anthony A. Olashore, Keneilwe Molebatsi, Caleb J. Othieno, and James O. Ayugi. "Mental health research in Botswana: a semi-systematic scoping review." Journal of International Medical Research 48, no. 10 (2020): 030006052096645. http://dx.doi.org/10.1177/0300060520966458.

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Mental and substance use disorders are a leading cause of disability worldwide. Despite this, there is a paucity of mental health research in low- and middle-income countries, especially in sub-Saharan Africa. We carried out a semi-systematic scoping review to determine the extent of mental health research in Botswana. Using a predetermined search strategy, we searched the databases Web of Science, PubMed, and EBSCOhost (Academic Search Complete, CINAHL with Full Text, MEDLINE, MEDLINE with Full Text, MLA International Bibliography, Open Dissertations) for articles written in English from inception to June 2020. We identified 58 studies for inclusion. The most researched subject was mental health aspects of HIV/AIDS, followed by research on neurotic and stress-related disorders. Most studies were cross-sectional and the earliest published study was from 1983. The majority of the studies were carried out by researchers affiliated to the University of Botswana, followed by academic institutions in the USA. There seems to be limited mental health research in Botswana, and there is a need to increase research capacity.

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26

Ben-Yami, Hanoch. "Circumcision: What should be done?" Journal of Medical Ethics 39, no. 7 (2013): 459–62. http://dx.doi.org/10.1136/medethics-2012-101274.

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27

Glass, Michael. "Forced circumcision of men (abridged)." Journal of Medical Ethics 40, no. 8 (2013): 567–71. http://dx.doi.org/10.1136/medethics-2013-101626.

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28

Short, R. V. "Male circumcision: a scientific perspective." Journal of Medical Ethics 30, no. 3 (2004): 241. http://dx.doi.org/10.1136/jme.2002.002576.

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29

Grande, Nuno R. "Commentary. Female circumcision in Nigeria—a note." Health Care Analysis 6, no. 1 (1998): 30–31. http://dx.doi.org/10.1002/(sici)1099-1042(199803)6:1<30::aid-hca2255>3.0.co;2-w.

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30

Wall, Andrew. "Commentary. Female circumcision in Nigeria—simply unethical?" Health Care Analysis 6, no. 1 (1998): 31–33. http://dx.doi.org/10.1002/(sici)1099-1042(199803)6:1<31::aid-hca3255>3.0.co;2-u.

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31

Erwin, Deborah O., and Chris Hackler. "Commentary. Female circumcision: a cross‐cultural conundrum." Health Care Analysis 6, no. 1 (1998): 35–39. http://dx.doi.org/10.1002/(sici)1099-1042(199803)6:1<35::aid-hca5255>3.0.co;2-o.

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32

Ogiamien, T. B. E. "A Legal Framework to Eradicate Female Circumcision." Medicine, Science and the Law 28, no. 2 (1988): 115–19. http://dx.doi.org/10.1177/002580248802800206.

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The traditional practices of genital mutilation1 of young girls and women, hereinafter called FC (female circumcision) have in recent times generated incessant controversy in political and academic circles. The campaign against the practice has similarly captured the interest of sociologists, interest groups and, until recent times, the law.2 Because of the medical dangers of FC, proposals to eradicate the activity have been suggestive of an outright ban; but others hold the view that the necessity for legislation to prohibit the practice will be unrealistic.3 As will be seen below, a few jurisdictions who have in the past partially legislated against it, met with little or no success. Paradoxically, the problem exists.4

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33

Akabayashi, Akira. "Female circumcision—A health issue or a human rights issue?" Health Care Analysis 6, no. 1 (1998): 55–58. http://dx.doi.org/10.1007/bf02678082.

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34

Ford, Paul J. "Physician Obligation, Cultural Factors, and Neonatal Male Circumcision." American Journal of Bioethics 3, no. 2 (2003): 58–59. http://dx.doi.org/10.1162/152651603766436270.

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35

Jones, Caroline McGee. "Neonatal Male Circumcision: Ethical Issues and Physician Responsibility." American Journal of Bioethics 3, no. 2 (2003): 59–60. http://dx.doi.org/10.1162/152651603766436289.

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36

Earp, Brian D. "The ethics of infant male circumcision." Journal of Medical Ethics 39, no. 7 (2013): 418–20. http://dx.doi.org/10.1136/medethics-2013-101517.

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37

Williams, Linda A. "Eradicating female circumcision: Human rights and cultural values." Health Care Analysis 6, no. 1 (1998): 33–35. http://dx.doi.org/10.1007/bf02678077.

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38

Akinsola, Henry A. "Ethical Issues in Rural Nursing Practice in Botswana." Nursing Ethics 8, no. 4 (2001): 340–49. http://dx.doi.org/10.1177/096973300100800406.

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The concern for ethical principles and values is not limited to health professionals alone. However, ethical principles in nursing act as safety valves for social control to prevent professional misconduct and abuse of the rights of clients. As a result of colonial experience, developing countries like Botswana usually follow the European lead, especially examples from the UK. This article examines the ethical problems and dilemmas associated with rural nursing practice in Botswana, a developing country in sub-Saharan Africa. The major ethical problems identified are related to the distribution of and access to health resources in rural communities. It is proposed that nurses must assume responsibility in the field of access and allocation by working collaboratively with governments and other professional bodies, and that nurses as a global community must work together as a team to support each other.

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39

Plank, Rebeca M., Joseph Makhema, Poloko Kebaabetswe, et al. "Acceptability of Infant Male Circumcision as Part of HIV Prevention and Male Reproductive Health Efforts in Gaborone, Botswana, and Surrounding Areas." AIDS and Behavior 14, no. 5 (2009): 1198–202. http://dx.doi.org/10.1007/s10461-009-9632-0.

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40

Waldeck, Sarah E. "Social Norm Theory and Male Circumcision: Why Parents Circumcise." American Journal of Bioethics 3, no. 2 (2003): 56–57. http://dx.doi.org/10.1162/152651603766436261.

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41

Sheldon, Mark. "Male Circumcision, Religious Preferences, and the Question of Harm." American Journal of Bioethics 3, no. 2 (2003): 61–62. http://dx.doi.org/10.1162/152651603766436298.

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42

Slosar, John Paul, and Daniel O'Brien. "The Ethics of Neonatal Male Circumcision: A Catholic Perspective." American Journal of Bioethics 3, no. 2 (2003): 62–64. http://dx.doi.org/10.1162/152651603766436306.

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43

Cruz, Rio, Leonard B. Glick, and John W. Travis. "Circumcision as Human-Rights Violation: Assessing Benatar and Benatar." American Journal of Bioethics 3, no. 2 (2003): 19–20. http://dx.doi.org/10.1162/152651603766436351.

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44

Akabayashi, Akira. "Commentary. Female circumcision—a health issue or a human rights issue?" Health Care Analysis 6, no. 1 (1998): 55–58. http://dx.doi.org/10.1002/(sici)1099-1042(199803)6:1<55::aid-hca9255>3.0.co;2-e.

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45

Williams, Linda A. "Commentary. Eradicating female circumcision: human rights and cultural values." Health Care Analysis 6, no. 1 (1998): 33–35. http://dx.doi.org/10.1002/(sici)1099-1042(199803)6:1<33::aid-hca4255>3.0.co;2-r.

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46

Fox, M., and M. Thomson. "HIV/AIDS and circumcision: lost in translation." Journal of Medical Ethics 36, no. 12 (2010): 798–801. http://dx.doi.org/10.1136/jme.2010.038695.

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47

Abu-Sahlieh, S. A. "No distinction between male and female circumcision." Journal of Medical Ethics 21, no. 5 (1995): 311. http://dx.doi.org/10.1136/jme.21.5.311.

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48

Morris, Brian J., John N. Krieger, Jeffrey D. Klausner, and Beth E. Rivin. "The Ethical Course Is To Recommend Infant Male Circumcision — Arguments Disparaging American Academy of Pediatrics Affirmative Policy Do Not Withstand Scrutiny." Journal of Law, Medicine & Ethics 45, no. 4 (2017): 647–63. http://dx.doi.org/10.1177/1073110517750603.

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We critically evaluate arguments in a recent Journal of Law, Medicine & Ethics article by Svoboda, Adler, and Van Howe disputing the 2012 affirmative infant male circumcision policy recommendations of the American Academy of Pediatrics. We provide detailed evidence in explaining why the extensive claims by these opponents are not supported by the current strong scientific evidence. We furthermore show why their legal and ethical arguments are contradicted by a reasonable interpretation of current U.S. and international law and ethics. After all considerations are taken into account it would be logical to conclude that failure to recommend male circumcision early in infancy may be viewed as akin to failure to recommend childhood vaccination to parents. In each case, parental consent is required and the intervention is not compulsory. Our evaluation leads us to dismiss the arguments by Svoboda et al. Instead, based on the evidence, infant male circumcision is both ethical and lawful.

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49

Svoboda, J. Steven. "Circumcision—A Victorian Relic Lacking Ethical, Medical, or Legal Justification." American Journal of Bioethics 3, no. 2 (2003): 52–54. http://dx.doi.org/10.1162/152651603766436243.

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50

Sabone, Motshedisi, Pelonomi Mazonde, Francesca Cainelli, et al. "Everyday ethical challenges of nurse-physician collaboration." Nursing Ethics 27, no. 1 (2019): 206–20. http://dx.doi.org/10.1177/0969733019840753.

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Background: Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings. Research question/aim: The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels of hospitals in Botswana (referral, district, and primary). Ethical considerations: Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants’ written informed consent was obtained. Findings: Respondents’ ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse–doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants’ views about how their work experiences could be improved. Discussion: Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom—and not a sufficient number of nursing staff. Conclusion: Collaboration between physicians and nurses is critical to optimizing patients’ health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment.

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