Chikutsa, Antony, Alfred C. Ncube, and Shepard Mutsau. 2013. Male Circumcision and Risky Sexual Behavior in Zimbabwe: Evidence from the 2010-11 Zimbabwe Demographic and Health Survey. DHS Working Papers No. 102. Calverton, Maryland, USA: ICF International.
Background: Zimbabwe has one of the highest HIV prevalence rates in the world, currently estimated at 15.2 percent among adults age 15-49. In 2009, voluntary medical male circumcision (VMMC) was adopted as an additional method of HIV prevention and since then has become a significant dimension of Zimbabwe’s HIV prevention strategy. The promotion of VMMC has raised a major concern that it might lead to an increase in high-risk sexual behavior, because circumcision could lead to a false sense of effective protection against HIV, a phenomenon known as risk compensation or behavioral disinhibition. According to the risk compensation hypothesis, as the risk of an undesirable outcome is reduced, people may compensate by behaving in riskier ways. In Zimbabwe, as in other countries with high HIV prevalence, male circumcision is
often promoted using evidence that it reduces the risk of HIV.
Purpose: This study sought to test whether circumcised men in Zimbabwe are more likely to have engaged in risky sexual behavior. The study also investigated the association among uncircumcised men between wanting male
circumcision and engaging in high-risk sexual behavior.
Data and methods: The study used data collected from men age 15-54 who were interviewed during the 2010-11 Zimbabwe Demographic and Health Survey (ZDHS). A total of 7,480 men were included in the sample for this study. Logistic regression was used to assess the association between circumcision and risky sexual behaviors.
Findings: The findings of this study do not support the risk compensation hypothesis. The study found no statistically significant association between male circumcision and risky sexual behavior. In contrast, the findings do show a strong association among uncircumcised men between wanting male circumcision and engaging in risky sexual behaviors.
Recommendations: Given the recency of the campaign to promote male circumcision in Zimbabwe, these results suggest a need to continue monitoring the relationships between ongoing VMCC campaigns and men’s risky sexual behavior. Communication and information dissemination on VMMC should emphasize caution in messages promoting medical male circumcision to avoid giving the impression that it provides immunity against HIV.