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Self-reported data on lack of sexual interest or pleasure, difficulty getting or maintaining erections, orgasm difficulties, premature ejaculation, pain during intercourse, and satisfaction with sexual intercourse were analyzed with mixed-effect models to detect differences between circumcised and uncircumcised men and changes over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Changes over time in sexual interest, desire and pleasure, erectile and ejaculatory function, and pain during intercourse (dyspareunia) in circumcised and uncircumcised men; group differences in time trends; satisfaction with sexual performance; and enjoyment of sex before and after circumcision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sexual dysfunctions decreased in the two study groups from 17% to 54% at baseline to 11% to 44% at 24 months (P &amp;lt; .001), except dyspareunia, which decreased only in circumcised men (P &amp;lt; .001). Sexual satisfaction outcomes increased in the two study groups from 34% to 82% at baseline to 66% to 93% at 24 months (P &amp;lt; .001), with greater improvements in circumcised men (P &amp;lt; .001). On average, 97% of circumcised men were satisfied with sexual intercourse and 92% rated sex as more enjoyable or no different after circumcision compared with before circumcision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Translation<\/jats:title>\n                  <jats:p>Results are applicable to VMMC programs seeking to increase the acceptability of male circumcision as part of comprehensive HIV prevention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>Large-scale population-based longitudinal data restricted to sexually active individuals and adjusted for differences in baseline levels of outcomes and potential confounders are used. The questionnaire used, although not a standardized survey instrument, includes all major domains of male sexual function and satisfaction used in the most common standardized tools.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Results are consistent with large cohort studies of VMMC using data from randomized controlled trials and indicate that VMMC has no significant detrimental effect or might have beneficial effects on male sexual function and satisfaction for the great majority of men circumcised as adults.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2017.02.014","type":"journal-article","created":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T16:31:51Z","timestamp":1490891511000},"page":"601-612","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["Medical Male Circumcision Is Associated with Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya"],"prefix":"10.1093","volume":"14","author":[{"given":"Monica P.C.","family":"Nordstrom","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Biostatistics \u00a0 , Chicago, IL , USA"},{"name":"University of Illinois at Chicago \u00a0 , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelli","family":"Westercamp","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics \u00a0 , Chicago, IL , USA"},{"name":"University of Illinois at Chicago \u00a0 , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Jaoko","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology \u00a0 , Nairobi , Kenya"},{"name":"University of Nairobi \u00a0 , Nairobi , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Okeyo","sequence":"additional","affiliation":[{"name":"Nyanza Reproductive Health Society , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics \u00a0 , Chicago, IL , USA"},{"name":"University of Illinois at Chicago \u00a0 , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,4,1]]},"reference":[{"key":"2023011111052887900_bib1","volume-title":"Voluntary medical male circumcision for HIV prevention fact\u00a0sheet 2012"},{"key":"2023011111052887900_bib2","article-title":"Global health sector response to HIV, 2000\u20132015: focus on innovations in Africa. 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