Study examines incentives to increase medical male circumcision to help reduce risk of HIV

July 21, 2014

Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately U.S. $9 or $15, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months, according to a study published by JAMA. The study is being released to coincide with its presentation at the International AIDS Conference.

Following randomized trials that demonstrated that medical male circumcision reduces men's risk of HIV acquisition by 50 percent to 60 percent, UNAIDS and the World Health Organization recommended the scale-up of voluntary medical male circumcision (VMMC) in 14 countries in eastern and southern Africa. Despite considerable scale-up efforts, most countries are far short of target goals. Novel strategies are needed to increase VMMC uptake. Potential barriers include concerns about lost wages during and after the procedure, according to background information in the article.

Harsha Thirumurthy, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues studied 1,504 uncircumcised men (25 to 49 years of age) in Nyanza region, Kenya, who were randomly assigned to 1 of 3 intervention groups or a . Participants in the intervention groups received varying amounts of compensation conditional on VMMC uptake at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of worth approximately U.S. $2.50, $8.75, or $15, which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation.

The researchers found VMMC uptake within 2 months was higher in the $8.75 group (6.6 percent [25 of 381]) and the $15 group (9.0 percent [34 of 377]) than in the $2.50 group (1.9 percent [7 of 374]) and the control group (1.6 percent [6 of 370]). Further analysis indicated that compared with participants in the control group, those in the $15 and $8.75 groups were significantly more likely to get circumcised; those enrolled in the $2.50 group were not. The difference in VMMC uptake between the $8.75 and $15 groups was not significant.

"There was also a significant increase in VMMC uptake among married and older participants, groups that have been harder to reach previously. The interventions also significantly increased the likelihood of circumcision uptake among participants at higher risk of acquiring HIV. This latter result is especially promising from an HIV prevention standpoint," the authors write.

"The overall increase in VMMC uptake within 2 months, as a result of providing compensation, was modest, with an increase of at most 7.4 percent in the U.S. $15.00 group. This increased uptake was in a population with an estimated circumcision prevalence of 35.6 percent. Evaluation of scaled-up implementation of the intervention is needed to determine whether it will help achieve higher coverage over longer periods of time."

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

More information: DOI: 10.1001/jama.2014.9087

Related Stories

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

July 21, 2014
Men do not engage in riskier behaviors after they are circumcised, according to a study in Kenya by University of Illinois at Chicago researchers.

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 ...

Scale-up of voluntary male circumcision cost-effective way to prevent HIV in S. and E. Africa

November 30, 2011
A collection of nine new articles to be published in PLoS Medicine and PLoS ONE, in conjunction with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States President's Emergency Plan for AIDS Relief ...

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 ...

Offering option of initial HIV care at home increases use of ART

July 19, 2014
LSTM Researchers found that offering adults in Malawi optional home initiation of care following HIV self-testing resulted in a significant increase in the proportion of adults initiating antiretroviral therapy (ART) compared ...

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.

Recommended for you

Scientists divulge latest in HIV prevention

July 25, 2017
A far cry from the 1990s "ABC" campaign promoting abstinence and monogamy as HIV protection, scientists reported on new approaches Tuesday allowing people to have all the safe sex they want.

Girl's HIV infection seems under control without AIDS drugs

July 24, 2017
A South African girl born with the AIDS virus has kept her infection suppressed for more than eight years after stopping anti-HIV medicines—more evidence that early treatment can occasionally cause a long remission that, ...

Meds by monthly injection might revolutionize HIV care (Update)

July 24, 2017
Getting a shot of medication to control HIV every month or two instead of having to take pills every day could transform the way the virus is kept at bay.

Candidate AIDS vaccine passes early test

July 24, 2017
The three-decade-old quest for an AIDS vaccine received a shot of hope Monday when developers announced that a prototype triggered the immune system in an early phase of human trials.

Paris spotlight on latest in AIDS science

July 21, 2017
Some 6,000 HIV experts gather in Paris from Sunday to report advances in AIDS science as fading hopes of finding a cure push research into new fields.

Scientists elicit broadly neutralizing antibodies to HIV in calves

July 20, 2017
Scientists supported by the National Institutes of Health have achieved a significant step forward, eliciting broadly neutralizing antibodies (bNAbs) to HIV by immunizing calves. The findings offer insights for HIV vaccine ...

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.