Sexual risk behaviors following circumcision among HIV-positive men in Rakai, Uganda

Bibliographic Data

ID19443677
AuthorsEdward Nelson Kankaka (0000-0001-6977-3405, Rakai Health Sciences Program, corresponding author), Joseph Ssekasanvu (0000-0002-3721-2299, Rakai Health Sciences Program), Jessica Prodger (Johns Hopkins University), Jessica L Prodger (0000-0003-0805-4196, Johns Hopkins University), Dorean Nabukalu (0000-0002-2680-0669, Rakai Health Sciences Program), Hadijja Nakawooya (0000-0002-0566-547X, Rakai Health Sciences Program), Anthony Ndyanabo (0000-0002-0087-9292, Rakai Health Sciences Program), Godfrey Kigozi (0009-0008-9142-6870, Rakai Health Sciences Program), Ronald H Gray (0000-0003-1952-6507, Rakai Health Sciences Program), Ronald Gray (Rakai Health Sciences Program)
Year2018
Volume30
Issue8
Pages990-996
Publication date2018-08-03
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2018.1437253
PMID29433386
OpenAlexW2792303438
LanguageEN
Citations received2
References cited18

OBJECTIVE: To determine whether circumcision of HIV-positive men is associated with increased subsequent sexual risk behaviors which may place their female partners at risk. METHODS: Newly circumcised and uncircumcised HIV-positive men in the Rakai Community Cohort Study were followed from baseline (July 2013-January 2015) to determine trend in sexual risk behaviors and association of circumcision with subsequent sexual risk behaviors at follow up (February 2015-September 2016). Risk behaviors included sexual activity, alcohol before sex, transactional sex, multiple sex partners, casual sex partners, and inconsistent condom use with casual partners. The association was evaluated using modified Poisson regression, and sensitivity analyses were performed after multiple imputation with chained equations for missing data. RESULTS: We identified 538 eligible men, of whom 113(21.0%) were circumcised at baseline and 425(79.0%) were uncircumcised. Men in fishing communities were more likely to be circumcised (p = 0.032) as well as those exposed to targeted HIV messaging (p < 0.001). Overall, 188(34.9%) men were lost to follow up and most were uncircumcised (p = 0.020). Among those followed up, behaviors remained largely unchanged with no differences by circumcision status. Transactional sex appeared to be associated with circumcision in unadjusted analyses (PR = 1.58, 95%CI = 1.01,2.48; p = 0.045, p = 0.05) and adjusted analyses (adj.PR = 1.54, 95%CI = 1.06,2.23; p = 0.022). However, the association was no longer significant in sensitivity analyses after accounting for loss to follow up (adj.PR = 1.43, 95%CI = 0.98,2.08; p = 0.066). No association with circumcision was observed for other sexual risk behaviors. CONCLUSION: We found no association between circumcision of HIV-positive men and subsequent sexual risk behavior

Casual · Cohort · Condom · Environmental health · Gynecology · Poisson regression · Population · Syphilis · Transactional sex · Demography · Female Genital Mutilation/Cutting Issues · Genital Health and Disease · Medicine · Sexual function and dysfunction studies · Immunology · Internal Medicine