Assessment of Changes in Risk Behaviors During 3 Years of Posttrial Follow-up of Male Circumcision Trial Participants Uncircumcised at Trial Closure in Rakai, Uganda
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Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
American journal of epidemiology
Abstract
Risk compensation associated with male circumcision has been a concern for male circumcision scale-up
programs. Using posttrial data collected during 2007–2011 on 2,137 male circumcision trial participants who
were uncircumcised at trial closure in Rakai, Uganda, the authors evaluated their sexual behavioral changes
during approximately 3 years’ follow-up after trial closure. Eighty-one percent of the men self-selected for male
circumcision during the period, and their sociodemographic and risk profiles were comparable to those of men
remaining uncircumcised. Linear models for marginal probabilities of repeated outcomes estimate that 3.3%
(P < 0.0001) of the male circumcision acceptors reduced their engagement in nonmarital relations, whereas
there was no significant change among men remaining uncircumcised. Significant decreases in condom use
occurred in both male circumcision acceptors (−9.2% with all partners and −7.0% with nonmarital partners) and
nonacceptors (−12.4% and −13.5%, respectively), and these were predominantly among younger men.
However, the magnitudes of decrease in condom use were not significantly different between the 2 groups.
Additionally, significant decreases in sex-related alcohol consumption were observed in both groups (−7.8% in
male circumcision acceptors and −6.1% in nonacceptors), mainly among older men. In summary, there was no
evidence of risk compensation associated with male circumcision among this cohort of men during 3 years of
posttrial follow-up.
Description
Keywords
Risk Behaviors, Male circumcision, Uncircumcised
Citation
Kong, X., Kigozi, G., Nalugoda, F., Musoke, R., Kagaayi, J., Latkin, C., ... & Gray, R. (2012). Assessment of changes in risk behaviors during 3 years of posttrial follow-up of male circumcision trial participants uncircumcised at trial closure in Rakai, Uganda. American journal of epidemiology, 176(10), 875-885.