Adult Circumcision Not Linked to Risky Sexual Behaviors

Circumcision does not promote risky sexual behavior, according to a new study conducted in Africa.

While circumcision has been shown to significantly reduce the risk of acquiring HIV, some experts believe that this type of "promotion" could increase promiscuity and decrease condom use.  Therefore the "risk compensation" could cut the effectiveness of medical male circumcision problems.

The latest study was conducted from 2008 to 2010 and involved 3,186 uncircumcised men participating in Kenya's national, voluntary medical circumcision program. The men in the study were aged 18 to 35 years old, and were evaluated every six months for two years.

The findings revealed that sexual activity increased equally in circumcised and uncircumcised men. This was especially true among the younger participants between the ages of 18 and 24 years old.

However, the study also revealed a significantly decline in risky sexual behaviors among participants in both study groups. Researchers explained that the use of condoms actually increased, and risky behaviors like paying for sex, having multiple sexual partners and engaging in casual sex actually decreased.

"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," first author and principal investigator Nelli Westercamp, a former University of Illinois at Chicago research project coordinator, said in a news release.

"It was very important to do a real life, population-level study to look at this question," she said.

"If men engaged in risky behaviors after circumcision, it could negate the protective effects," Westercamp  added.

Senior author Robert Bailey, a professor of epidemiology at the University of Illinois at Chicago said the latest finding "provides the best evidence to date that concerns about risk compensation should not impede widespread implementation of voluntary male medical circumcision programs."

The findings are published online July 21 in the journal AIDS and Behavior.