Circumcision does not promote risky behavior by African men, study says

July 21, 2014, University of Illinois at Chicago

Men do not engage in riskier behaviors after they are circumcised, according to a study in Kenya by University of Illinois at Chicago researchers.

Three clinical trials have shown that male significantly reduces the risk of acquiring HIV in young African men. However, some experts have suggested that circumcision, if promoted as an HIV preventive, may increase promiscuity or decrease condom use. This 'risk compensation' could diminish the effectiveness of medical male circumcision programs.

The new study, published online July 21 in the journal AIDS and Behavior, is the first population-level longitudinal assessment of risk compensation associated with adult .

The study was conducted during the implementation of the national, voluntary medical circumcision program in the east African country of Kenya. From 2008 to 2010, 3,186 uncircumcised men from Nyanza Province participated in the study. Half were circumcised shortly after their baseline assessment, while half chose to remain uncircumcised.

The men, between 18 and 35 years old, were assessed every six months for two years. They were asked about their perceived risk of acquiring HIV, sexual behaviors, and condom use. All participants, whether circumcised or uncircumcised, were encouraged to attend HIV testing and counseling services at clinics, where they were exposed to HIV educational videos playing in the waiting areas. Participants did not receive direct risk-reduction counseling during visits.

Sexual activity increased equally in the circumcised and uncircumcised men, particularly among the youngest, those 18-24 years old. But despite an increase in sexual activity, all other declined in both study groups, and condom use increased. Risky behaviors, which included engaging in sex in exchange for money or gifts, sex with a casual partner, or having multiple sex partners, declined considerably among both groups.

Men who were circumcised often perceived they had lessened their risk of acquiring HIV. Thirty percent considered themselves high- risk before circumcision, while just 14 percent considered themselves so after. Among those who chose not to be circumcised, 24 percent considered themselves high-risk at the beginning of the study and 21 percent still did at the end. However, the differences in perception of risk did not translate into differences in risky behavior over the two years of the study.

"Countries that have been holding back on implementing medical circumcision programs due to a lack of evidence regarding risk compensation should have no concerns about scaling-up programs," said Nelli Westercamp, the principal investigator and first author of the study who is a former UIC research project coordinator.

"It was very important to do a real life, population-level study to look at this question," she said. "If engaged in after circumcision, it could negate the protective effects."

The study "provides the best evidence to date that concerns about risk compensation should not impede widespread implementation of voluntary male medical circumcision programs," said the study's senior author, Robert Bailey, professor of epidemiology at UIC.

Explore further: Circumcision linked to reduced risk of prostate cancer in some men

Related Stories

Circumcision linked to reduced risk of prostate cancer in some men

May 29, 2014
Circumcision is performed for various reasons, including those that are based on religion, aesthetics, or health. New research indicates that the procedure may help prevent prostate cancer in some men. The findings, which ...

Roll-out of community voluntary male circumcision is linked to reduced HIV infection levels

September 3, 2013
Roll-out of voluntary male circumcision services into the community of Orange Farm, South Africa is linked to substantial reductions in HIV infection levels, according to a study published in this week's PLOS Medicine. The ...

HIV battle: Uganda tests out rubber band circumcision

June 17, 2014
With trousers around his ankles, Justin Igalla awaits a tight rubber band for his foreskin, an innovative non-surgical technique rolling out in several African nations to encourage circumcision and cut HIV infection rates.

Circumcision could prevent prostate cancer... if it's performed after the age of 35

April 7, 2014
Researchers at the University of Montreal and the INRS-Institut-Armand-Frappier have shown that men circumcised after the age of 35 were 45% less at risk of later developing prostate cancer than uncircumcised men.

Recommended for you

HIV-1 genetic diversity is higher in vaginal tract than in blood during early infection

January 18, 2018
A first-of-its-kind study has found that the genetic diversity of human immunodeficiency virus type 1 (HIV-1) is higher in the vaginal tract than in the blood stream during early infection. This finding, published in PLOS ...

War in Ukraine has escalated HIV spread in the country: study

January 15, 2018
Conflict in Ukraine has increased the risk of HIV outbreaks throughout the country as displaced HIV-infected people move from war-affected regions to areas with higher risk of transmission, according to analysis by scientists.

Researchers offer new model for uncovering true HIV mortality rates in Zambia

January 12, 2018
A new study that seeks to better ascertain HIV mortality rates in Zambia could provide a model for improved national and regional surveillance approaches, and ultimately, more effective HIV treatment strategies.

New drug capsule may allow weekly HIV treatment

January 9, 2018
Researchers at MIT and Brigham and Women's Hospital have developed a capsule that can deliver a week's worth of HIV drugs in a single dose. This advance could make it much easier for patients to adhere to the strict schedule ...

New long-acting, less-toxic HIV drug suppresses virus in humanized mice

January 8, 2018
A team of Yale researchers tested a new chemical compound that suppresses HIV, protects immune cells, and remains effective for weeks with a single dose. In animal experiments, the compound proved to be a promising new candidate ...

Usage remains low for pill that can prevent HIV infection

January 8, 2018
From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which—in their view—remains woefully ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.