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Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...

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14.5 MALE CIRCUMCISION<br />

Male circumcision has been shown to be associated<br />

with lower transmission <strong>of</strong> STIs, including HIV<br />

(WHO <strong>and</strong> UNAIDS, 2007). To know the practice <strong>of</strong><br />

male circumcision in <strong>Timor</strong>-<strong>Leste</strong>, men age 15-49<br />

interviewed in the <strong>2009</strong>-<strong>10</strong> TLDHS were asked if they<br />

were circumcised.<br />

As seen in Table 14.8 male circumcision is not<br />

widespread in <strong>Timor</strong>-<strong>Leste</strong>, <strong>and</strong> only 6 percent <strong>of</strong> men<br />

have been circumcised. The practice is slightly more<br />

common among men age 25 <strong>and</strong> older, among men with<br />

little or no education, <strong>and</strong> among men in the lowest<br />

wealth quintile. The vast majority <strong>of</strong> circumcised men<br />

live in Oecussi.<br />

14.6 REPORTS OF RECENT SEXUALLY TRANSMITTED<br />

INFECTIONS<br />

Information about the prevalence <strong>of</strong> sexually<br />

transmitted infections (STIs) is useful not only as a<br />

marker <strong>of</strong> unprotected sexual intercourse but also as a<br />

c<strong>of</strong>actor for HIV transmission. The <strong>2009</strong>-<strong>10</strong> TLDHS<br />

asked respondents who had ever had sex whether they<br />

had had an STI in the past 12 months. They were also<br />

asked whether, in the past year, they had experienced a<br />

genital sore or ulcer, <strong>and</strong> whether they had any genital<br />

discharge. These symptoms are useful in identifying<br />

STIs in men. They are less easily interpreted in women<br />

because women are likely to experience more non-STI<br />

conditions <strong>of</strong> the reproductive tract that produce a genital<br />

discharge.<br />

Table 14.8 Male circumcision<br />

Percentage <strong>of</strong> men age 15-49 who report having<br />

been circumcised, by background characteristics,<br />

<strong>Timor</strong>-<strong>Leste</strong> <strong>2009</strong>-<strong>10</strong><br />

Background<br />

characteristic<br />

Percentage<br />

circumcised<br />

Number <strong>of</strong><br />

men<br />

Age<br />

15-24 4.2 1,636<br />

15-19 4.4 994<br />

20-24 3.8 643<br />

25-29 7.4 586<br />

30-39 8.5 992<br />

40-49<br />

Residence<br />

7.5 861<br />

Urban 6.6 1,<strong>10</strong>2<br />

Rural<br />

District<br />

6.3 2,974<br />

Aileu 2.5 181<br />

Ainaro 1.3 217<br />

Baucau 0.8 415<br />

Bobonaro 2.6 357<br />

Covalima 0.8 236<br />

Dili 4.4 797<br />

Ermera 0.6 491<br />

Lautem 0.2 308<br />

Liquiçá 0.8 252<br />

Manatuto 0.7 190<br />

Manufahi 0.0 137<br />

Oecussi 83.0 235<br />

Viqueque<br />

Education<br />

0.9 260<br />

No education 8.0 791<br />

Primary 9.0 1,046<br />

Secondary 4.5 2,009<br />

More than secondary<br />

Wealth quintile<br />

5.2 230<br />

Lowest 13.0 728<br />

Second 5.7 781<br />

Middle 4.6 786<br />

Fourth 4.7 849<br />

Highest 4.8 932<br />

Total 15-49 6.4 4,076<br />

In general, STIs are acquired through unprotected sexual intercourse <strong>and</strong> through the<br />

introduction <strong>of</strong> infected blood <strong>and</strong> blood products. STIs may also be transmitted from mother to fetus<br />

<strong>and</strong> from mother to neonate/infant during pregnancy <strong>and</strong> during the postpartum <strong>and</strong> breastfeeding<br />

periods (MOH, 2007).<br />

Table 14.9 shows that self-reported prevalence <strong>of</strong> STIs <strong>and</strong> STI symptoms is relatively low,<br />

with prevalence among women higher than among men. About 1 percent <strong>of</strong> women <strong>and</strong> men reported<br />

STI prevalence in the 12 months prior to the survey. It is likely that these figures, which are quite low,<br />

underestimate the actual prevalence <strong>of</strong> STIs among the sexually active population in <strong>Timor</strong>-<strong>Leste</strong>.<br />

Many STI symptoms are not easily recognized, <strong>and</strong> <strong>of</strong>ten STIs do not have any visible symptoms.<br />

Eight percent <strong>of</strong> women <strong>and</strong> 2 percent <strong>of</strong> men age 15-49 report having had a bad-smelling or<br />

abnormal genital discharge, 4 percent <strong>of</strong> women <strong>and</strong> 3 percent <strong>of</strong> men report a genital sore or ulcer,<br />

<strong>and</strong> twice as many women as men (8 percent <strong>and</strong> 4 percent, respectively) report having had an STI,<br />

genital discharge, or sore or ulcer in the past 12 months.<br />

HIV/AIDS-Related Knowledge, Attitudes, <strong>and</strong> Behavior | 193

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