It is scientifically accepted that circumcision reduces men acquiring HIV by approximately 60 percent!
However, a number of proponents against circumcision say that the message gets lost in translation and that men assume that they cannot acquire HIV and hence, practice more risky behaviour after getting circumcised.
Well, there is very good evidence now that is not true. Three large studies in South Africa, Zimbabwe and Kenya have found no evidence that men who have been circumcised have more sexual risk behaviours than uncircumcised men.
It has been postulated that ‘risk compensation’ or ‘behavioural disinhibition’ after circumcision could reduce the protective effect of circumcision in decreasing HIV infection if people changed their sexual behaviour as a result of perceiving themselves to be less at risk of infection.
A study assessed ‘risk compensation’ in 15 000 men in South Africa, including 13 percent who had been circumcised and six percent who were circumcised during the period of study 2003-2014. ‘Risk compensation’ was assessed by considering four aspects of sexual behavior: not using a condom the last time the man had sex, never using condoms, the number of sexual partners, and the number of concurrent sexual relationships. As well as simply comparing circumcised and uncircumcised men, the researchers also compared behaviour before and after an individual’s circumcision.
The researchers found no evidence for risk compensation following circumcision. If anything, men who were circumcised had slightly decreased risk-taking behaviour, although the differences weren’t statistically significant.
Similar results in Zimbabwe. Men who received an HIV negative test and then got circumcised, following them up after two years, the researchers found no evidence that circumcised men had greater increases in risk behaviour over time than uncircumcised men.
Again in Kenya, researchers found the prevalence of circumcision increased but found no difference between circumcised and uncircumcised men in sexual behaviour (including condom use and number of sexual partners) or in knowledge about HIV or perception of HIV risk.
So the results are clear voluntary male medical circumcision should continue to be scaled up!