Voluntary Medical Safe Male Circumcision for HIV/AIDS Prevention in Botswana: Background, Patterns, and Determinants

The safe male circumcision program has been running for about 10 years now, in Botswana. This chapter uses data derived from the two Botswana AIDS Impact Surveys (BAIS III and IV) conducted in 2008 and 2013, the period before and after the implementation of the SMC program to assess the background, patterns, and correlates of safe male circumcision. Data were analyzed using multivariate logistic regression models. Overall, 785 (12.5%) and 956 (25.2%) men reported to have been circumcised in 2008 and 2013, respectively. Elderly men aged 55–64 years were more likely to have been circumcised than men aged 10–24 years (APR = 3.40, CI = 2.00–5.76 in 2008 and APR = 3.63, CI = 2.36–5.57 in 2013). Men with primary or low and secondary education and those who reside in rural villages (APR = 0.70, CI = 0.54–0.89 in 2008; APR = 0.71, CI = 0.58–0.86 in 2013) were less likely to have been circumcised compared to men who resided in cities and towns. The odds of circumcision were also significantly low among never married (APR = 0.43, CI = 0.24–0.76) and cohabiting (APR = 0.45, CI = 0.26–0.80) men than once-married men in 2008. In 2013, the odds of circumcision were significantly low among married men (APR = 0.93, CI = 0.47–1.82). Understanding the background, patterns, and correlates of safe male circumcision is essential for programming and assessment of the effectiveness of the program.