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A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland.
AIDS Care. 2012; 24(2):245-51.AC

Abstract

Male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomized controlled trials. Less is known, however, about sexual behavior change in men who have been circumcised and whether male circumcision's protective effect leads to riskier sexual behaviors. This study used qualitative in-depth interviews to understand men's sexual behavior after circumcision and to determine whether and how men participated in riskier sexual behaviors following male circumcision. Men in urban Swaziland, circumcised in the previous 12 months, were recruited and asked about their perceptions of sexual risk and sexual behavior post-circumcision. Results showed that following circumcision, men experience changes in both their sexual attitudes and behavior, which can be considered both protective and risky for HIV transmission. Most of them described protective changes (e.g., more responsible attitudes towards safe sex, reducing sexual temptation and partners, easier condom use). A minority, however, experienced increased sexual risk-taking, typically during a brief period of sexual experimentation shortly after circumcision. HIV counseling and counseling throughout the circumcision process is shown to be critical in influencing protective behaviors. Findings in this study confirm the existence of risk compensation following circumcision; however, this study adds important contextual insight about precisely when and why such risk-taking occurs. Nevertheless this study suggests that male circumcision scale-up as an HIV prevention strategy is likely to foster protective behavior change among men. The integration of HIV counseling with circumcision provision remains critical for effectively mitigating HIV risk behavior as male circumcision gains momentum as a viable HIV prevention tool.

Authors+Show Affiliations

Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. jonathangrund@gmail.comNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21777079

Citation

Grund, Jonathan M., and Monique M. Hennink. "A Qualitative Study of Sexual Behavior Change and Risk Compensation Following Adult Male Circumcision in Urban Swaziland." AIDS Care, vol. 24, no. 2, 2012, pp. 245-51.
Grund JM, Hennink MM. A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland. AIDS Care. 2012;24(2):245-51.
Grund, J. M., & Hennink, M. M. (2012). A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland. AIDS Care, 24(2), 245-51. https://doi.org/10.1080/09540121.2011.596516
Grund JM, Hennink MM. A Qualitative Study of Sexual Behavior Change and Risk Compensation Following Adult Male Circumcision in Urban Swaziland. AIDS Care. 2012;24(2):245-51. PubMed PMID: 21777079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland. AU - Grund,Jonathan M, AU - Hennink,Monique M, Y1 - 2011/07/21/ PY - 2011/7/23/entrez PY - 2011/7/23/pubmed PY - 2012/5/10/medline SP - 245 EP - 51 JF - AIDS care JO - AIDS Care VL - 24 IS - 2 N2 - Male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomized controlled trials. Less is known, however, about sexual behavior change in men who have been circumcised and whether male circumcision's protective effect leads to riskier sexual behaviors. This study used qualitative in-depth interviews to understand men's sexual behavior after circumcision and to determine whether and how men participated in riskier sexual behaviors following male circumcision. Men in urban Swaziland, circumcised in the previous 12 months, were recruited and asked about their perceptions of sexual risk and sexual behavior post-circumcision. Results showed that following circumcision, men experience changes in both their sexual attitudes and behavior, which can be considered both protective and risky for HIV transmission. Most of them described protective changes (e.g., more responsible attitudes towards safe sex, reducing sexual temptation and partners, easier condom use). A minority, however, experienced increased sexual risk-taking, typically during a brief period of sexual experimentation shortly after circumcision. HIV counseling and counseling throughout the circumcision process is shown to be critical in influencing protective behaviors. Findings in this study confirm the existence of risk compensation following circumcision; however, this study adds important contextual insight about precisely when and why such risk-taking occurs. Nevertheless this study suggests that male circumcision scale-up as an HIV prevention strategy is likely to foster protective behavior change among men. The integration of HIV counseling with circumcision provision remains critical for effectively mitigating HIV risk behavior as male circumcision gains momentum as a viable HIV prevention tool. SN - 1360-0451 UR - https://www.unboundmedicine.com/medline/citation/21777079/A_qualitative_study_of_sexual_behavior_change_and_risk_compensation_following_adult_male_circumcision_in_urban_Swaziland_ L2 - https://www.tandfonline.com/doi/full/10.1080/09540121.2011.596516 DB - PRIME DP - Unbound Medicine ER -