AIDS and Behavior

, Volume 18, Issue 9, pp 1764–1775

Risk Compensation Following Male Circumcision: Results from a Two-Year Prospective Cohort Study of Recently Circumcised and Uncircumcised Men in Nyanza Province, Kenya

  • Nelli Westercamp
  • Kawango Agot
  • Walter Jaoko
  • Robert C. Bailey
Original Paper

DOI: 10.1007/s10461-014-0846-4

Cite this article as:
Westercamp, N., Agot, K., Jaoko, W. et al. AIDS Behav (2014) 18: 1764. doi:10.1007/s10461-014-0846-4

Abstract

We present the results of the first study of longitudinal change in HIV-associated risk behaviors in men before and after circumcision in the context of a population-level voluntary medical male circumcision (VMMC) program. The behaviors of 1,588 newly circumcised men and 1,598 age-matched uncircumcised controls were assessed at baseline, 6, 12, 18 and 24 months of follow-up. Despite the precipitous decline in perception of high HIV risk among circumcised men (30–14 vs. 24–21 % in controls) and increased sexual activity among the youngest participants (18–24 years; p-time < 0.0001, p-group = 0.96), all specific risk behaviors decreased over time similarly in both groups. The proportion of men reporting condom use at last sex increased for both groups, with a greater increase among circumcised men (30 vs. 6 %). We found no evidence of risk compensation in men following circumcision. Concerns about risk compensation should not impede the widespread scale-up of VMMC initiatives.

Keywords

Risk compensationBehavioral disinhibitionMale circumcisionHIV/AIDSSexual behaviorAfrica

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Nelli Westercamp
    • 1
  • Kawango Agot
    • 2
  • Walter Jaoko
    • 3
  • Robert C. Bailey
    • 1
  1. 1.Division of Epidemiology and Biostatistics, School of Public HealthUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Impact Research and Development OrganizationKisumuKenya
  3. 3.Department of Medical MicrobiologyUniversity of NairobiNairobiKenya