Abstract:
After a series of studies that revealed the
protective effect of male circumcision
against HIV infection, WHO/UNAIDS in 2007
recommended the adoption of safe male
circumcision as one of the effective
strategies in reducing heterosexually
acquired HIV. To this effect, in 2010 the
Ministry of Health in Uganda developed a
circumcision policy, and circumcision was
added to the strategy of abstinence, being
faithful, and condom use (ABC) to protect
against AIDS. Especially after the
implementation of the safe
male circumcision (SMC) policy, however,
there has been a concern that some
circumcised men may lead a more risky sexual
lifestyle than non-
circumcised men. This paper, therefore,
examines the associations am
ong circumcision status, age at circumcision,
risky sexual behavi
ors, and HIV serostatus among men.
The paper uses data from the 2011 Uganda AIDS
Indicator Survey, focusing on a subsample of
7,969 weighted cases of men age 15-59 who
have ever had sex and who have received their
HIV test results. The paper examines
associations between risky sexual behaviors
and circumcision status among all men, and
associations between risky sexual behaviors
and age at circumcision among circumcised
men. At the multivariate level, the paper
establishes the independent relationships
between circumcision status and age at
circumcision, risky sexual behaviors, and HIV
serostatus.
Results show that 28% of men in Uganda have
been circumcised, and the majority were
circumcised before age 10. At the bivariate
level, circumcision status is not independent
of risky sexual behaviors. Results from the
logistic regression models show that
circumcised men are more likely to engage in
risky sexual behaviors, while age at
circumcision is not significantly associated
with these behaviors. Circumcised men are
also less likely to be HIV-positive.
The findings suggest a need to repackage the
circumcision messages to account for the
increased risky sexual behaviors among men
who have been circumcised. Intensified,
individual tailored counseling before and af
ter SMC procedures may help to reduce these
risky behaviors. Furthermore, qualitative
research should explore the reasons for
circumcision and the drivers for risky sexual
behavior.
Male Circumcision, Sexual Behavior, and HIV Status in Uganda (PDF, 480K)