Current HIV/AIDS Reports

, Volume 6, Issue 4, pp 187–193 | Cite as

Behavioral aspects of male circumcision for the prevention of HIV infection

Article

Abstract

Male circumcision (MC) can prevent female-to-male HIV transmission and has the potential to significantly alter HIV epidemics. The ultimate impact of MC on HIV prevention will be determined, in part, by behavioral factors. In order to fully realize the protective benefits of MC, factors related to acceptability and sexual risk must be considered. Research shows that acceptability of MC among uncircumcised men is high, and suggests that free and safe circumcision may be taken up in places with high HIV prevalence. Perceptions of adverse effects of MC may, however, limit uptake. Furthermore, considerable risk reduction counseling provided by MC trials limits our ability to understand the impact MC may have on behavior. There is also no evidence that MC protects women with HIV-positive partners or that it offers protection during anal intercourse. Research is urgently needed to better understand and manage the behavioral implications of MC for HIV prevention.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Kalichman SC: Time to take stock in HIV/AIDS prevention. AIDS Behav 2008, 12:333–334.CrossRefPubMedGoogle Scholar
  2. 2.
    Moses S, Plummer FA, Bradley JE, et al.: The association between lack of male circumcision and risk for HIV infection: a review of the epidemiological data. Sex Transm Dis 1994, 21:201–210.PubMedGoogle Scholar
  3. 3.
    Quinn TC: Circumcision and HIV transmission. Curr Opin Infect Dis 2007, 20:33–38.CrossRefPubMedGoogle Scholar
  4. 4.
    Morris BJ: Why circumcision is a biomedical imperative for the 21(st) century. Bioessays 2007, 29:1147–1158.CrossRefPubMedGoogle Scholar
  5. 5.
    Auvert B, Taljaard D, Lagarde E, et al.: Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial. PLoS Med 2005, 11:1112–1122.Google Scholar
  6. 6.
    Bailey RC, Moses S, Parker CB, et al.: Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial. Lancet 2007, 369:643–656.CrossRefPubMedGoogle Scholar
  7. 7.
    Gray RH, Kigozi G, Serwadda D, et al.: Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 2007, 369:657–666.CrossRefPubMedGoogle Scholar
  8. 8.
    Byakika-Tusiime J: Circumcision and HIV infection: assessment of causality. AIDS Behav 2008, 12:835–841.CrossRefPubMedGoogle Scholar
  9. 9.
    Cameron DW, Simonsen JN, D’Costa LJ, et al.: Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Lancet 1989, 2:403–407.CrossRefPubMedGoogle Scholar
  10. 10.
    Telzak EE, Chiasson MA, Bevier PJ, et al.: HIV-1 seroconversion in patients with and without genital ulcer disease. A prospective study. Ann Intern Med 1993, 119:1181–1186.PubMedGoogle Scholar
  11. 11.
    Sassan-Morokro M, Greenberg AE, Coulibaly IM, et al.: High rates of sexual contact with female sex workers, sexually transmitted diseases, and condom neglect among HIV-infected and uninfected men with tuberculosis in Abidjan, Cote d’Ivoire. J Acquir Immune Defic Syndr Hum Retrovirol 1996, 11:183–187.PubMedGoogle Scholar
  12. 12.
    Quigley M, Munguti K, Grosskurth H, et al.: Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study. AIDS 1997, 11:237–248.CrossRefPubMedGoogle Scholar
  13. 13.
    Lavreys L, Rakwar JP, Thompson ML, et al.: Effect of circumcision on incidence of human immunodeficiency virus type 1 and other sexually transmitted diseases: a prospective cohort study of trucking company employees in Kenya. J Infect Dis 1999, 180:330–336.CrossRefPubMedGoogle Scholar
  14. 14.
    MacDonald KS, Malonza I, Chen DK, et al.: Vitamin A and risk of HIV-1 seroconversion among Kenyan men with genital ulcers. AIDS 2001, 15:635–639.CrossRefPubMedGoogle Scholar
  15. 15.
    Kumwenda NI, Taha TE, Hoover DR, et al.: HIV-1 incidence among male workers at a sugar estate in rural Malawi. J Acquir Immune Defic Syndr 2001, 27:202–208.PubMedGoogle Scholar
  16. 16.
    Reynolds SJ, Shepherd ME, Risbud AR, et al.: Male circumcision and risk of HIV-1 and other sexually transmitted infections in India. Lancet 2004, 363:1039–1040.CrossRefPubMedGoogle Scholar
  17. 17.
    Shaffer D, Bautista C, Sateren W, et al.: The protective effect of circumcision on HIV incidence in rural low-risk men circumcised predominantly by traditional circumcisers in Kenya: two-year follow-up of the Kericho Cohort Study. J Acquir Immune Defic Syndr 2007, 45:371–379.CrossRefPubMedGoogle Scholar
  18. 18.
    Hill BA: The environment and disease: association or causation? Proc R Soc Med 1965, 58:295–300.PubMedGoogle Scholar
  19. 19.
    Bollinger LA, Stover J, Musuka G, et al.: The cost and impact of male circumcision on HIV/AIDS in Botswana. J Int AIDS Soc 2009, 12:7.CrossRefPubMedGoogle Scholar
  20. 20.
    WHO/UNAIDS: New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications. Montreux, Switzerland: WHO/UNAIDS Technical Consultation; 2007.Google Scholar
  21. 21.
    Siegfried N, Muller M, Volmink J, et al.: Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev 2003, CD003362.Google Scholar
  22. 22.
    Westercamp N, Bailey RC: Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: a review. AIDS Behav 2007, 11:341–355.CrossRefPubMedGoogle Scholar
  23. 23.
    Ruan Y, Qian HZ, Li D, et al.: Willingness to be circumcised for preventing HIV among Chinese men who have sex with men. AIDS Patient Care STDS 2009, 23:315–321.CrossRefPubMedGoogle Scholar
  24. 24.
    Begley EB, Jafa K, Voetsch AC, et al.: Willingness of men who have sex with men (MSM) in the United States to be circumcised as adults to reduce the risk of HIV infection. PLoS ONE 2008, 3:e2731.CrossRefPubMedGoogle Scholar
  25. 25.
    Ngalande RC, Levy J, Kapondo C, Bailey R: Acceptability of male circumcision for prevention of HIV infection in Malawi. AIDS Behav 2006, 10:377–385.CrossRefPubMedGoogle Scholar
  26. 26.
    Muula AS: Male circumcision to prevent HIV transmission and acquisition: what else do we need to know? AIDS Behav 2007, 11:357–363.CrossRefPubMedGoogle Scholar
  27. 27.
    Bruyn G, Martinson NA, Nkala BD, et al.: Uptake of male circumcision in an HIV vaccine efficacy trial. J Acquir Immune Defic Syndr 2009, 51:108–110.PubMedCrossRefGoogle Scholar
  28. 28.
    Fink KS, Carson CC, DeVellis RF: Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction. J Urol 2002, 167:2113–2116.CrossRefPubMedGoogle Scholar
  29. 29.
    Masood S, Patel HR, Himpson RC, et al.: Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly? Urol Int 2005, 75:62–66.CrossRefPubMedGoogle Scholar
  30. 30.
    Kim D, Pang MG: The effect of male circumcision on sexuality. BJU Int 2007, 99:619–622.CrossRefPubMedGoogle Scholar
  31. 31.
    Krieger JN, Mehta SD, Bailey RC, et al.: Adult male circumcision: effects on sexual function and sexual satisfaction in Kisumu, Kenya. J Sex Med 2008, 5:2610–2622.CrossRefPubMedGoogle Scholar
  32. 32.
    Peltzer K, Nqeketo A, Petros G, Kanta X: Traditional circumcision during manhood initiation rituals in the Eastern Cape, South Africa: a pre-post intervention evaluation. BMC Public Health 2008, 8:64.CrossRefPubMedGoogle Scholar
  33. 33.
    Eaton LA, Kalichman SC: Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies. Curr HIV/AIDS Rep 2007, 4:165–172.CrossRefPubMedGoogle Scholar
  34. 34.
    Mattson CL, Campbell RT, Bailey RC, et al.: Risk compensation is not associated with male circumcision in Kisumu, Kenya: a multi-faceted assessment of men enrolled in a randomized controlled trial. PLoS One 2008, 6:1–9.Google Scholar
  35. 35.
    Agot KE, Kiarie JN, Nguyen HQ, et al.: Male circumcision in Siaya and Bondo districts, Kenya: prospective cohort study to assess behavioral disinhibition following circumcision. J Acquir Immune Defic Syndr 2007, 44:66–70.CrossRefPubMedGoogle Scholar
  36. 36.
    Bailey RC, Muga R, Poulussen R, Abicht H: The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya. AIDS Care 2002, 1:27–40.Google Scholar
  37. 37.
    Warner L, Ghanem KG, Newman DR, et al.: Male circumcision and risk of HIV infection among heterosexual African American men attending Baltimore sexually transmitted disease clinics. J Infect Dis 2009, 199:59–65.CrossRefPubMedGoogle Scholar
  38. 38.
    Reynolds G, Latimore A, Fisher D: Heterosexual anal sex among female drug users: U.S. national compared to local Long Beach, California data. AIDS Behav 2008, 12:796–805.CrossRefPubMedGoogle Scholar
  39. 39.
    Kalichman SC, Simbayi LC, Cain D, Jooste S: Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. Sex Transm Infect 2009 May 7 (Epub ahead of print).Google Scholar
  40. 40.
    Kigozi G, Gray RH, Wawer MJ, et al.: The safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda. PLoS Med 2008, 5:e116.CrossRefPubMedGoogle Scholar
  41. 41.
    Millett GA, Ding H, Lauby J, et al.: Circumcision status and HIV infection among black and Latino men who have sex with men in 3 US cities. J Acquir Immune Defic Syndr 2007, 46:643–650.CrossRefPubMedGoogle Scholar
  42. 42.
    Millett GA, Flores SA, Marks G, et al.: Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men: a meta-analysis. JAMA 2008, 300:1674–1784.CrossRefPubMedGoogle Scholar
  43. 43.
    Connolly C, Simbayi LC, Shanmugam R, Nqeketo A: Male circumcision and its relationship to HIV infection in South Africa: results of a national survey in 2002. S Afr Med J 2008, 98:789–794.PubMedGoogle Scholar
  44. 44.
    Dickson NP, van Roode T, Herbison P, Paul C: Circumcision and risk of sexually transmitted infections in a birth cohort. J Pediatr 2008, 152:383–387.CrossRefPubMedGoogle Scholar
  45. 45.
    Brooks R, Etzel M, Klosinski L, et al.: Male circumcision and HIV prevention: looking to the future. AIDS Behav 2009 Feb 11 (Epub ahead of print).Google Scholar
  46. 46.
    Sawires SR, Dworkin SL, Fiamma A, et al.: Male circumcision and HIV/AIDS: challenges and opportunities. Lancet 2007, 369:708–713.CrossRefPubMedGoogle Scholar

Copyright information

© Current Medicine Group, LLC 2009

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of ConnecticutStorrsUSA

Personalised recommendations