Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting.
<h4>Background</h4>Clinical trials have clearly shown a reduction in HIV acquisition through voluntary medical male circumcision (VMMC). However, data assessing risk compensation under programmatic conditions is limited.<h4>Methods</h4>This was a prospective cohort of HIV ser...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2019-01-01
|
Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0213571 |
id |
doaj-c83e3e8d7f2d474dbe2f4095c539dddb |
---|---|
record_format |
Article |
spelling |
doaj-c83e3e8d7f2d474dbe2f4095c539dddb2021-03-04T10:35:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01143e021357110.1371/journal.pone.0213571Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting.Hillary MukuduJanan DietrichKennedy OtwombeMmatsie ManentsaKhuthadzo HlongwaneMaetal Haas-KoganBenn SartoriusNeil Martinson<h4>Background</h4>Clinical trials have clearly shown a reduction in HIV acquisition through voluntary medical male circumcision (VMMC). However, data assessing risk compensation under programmatic conditions is limited.<h4>Methods</h4>This was a prospective cohort of HIV seronegative males aged 18-40 years receiving VMMC between November 2012 and July 2014. HIV serostatus was determined pre and post VMMC. Risk compensation was defined as a decrease in condom use at last sex act and/or an increase in concurrent sexual relationships, both measured twelve months post-circumcision.<h4>Results</h4>A total of 233 males were enrolled and underwent voluntary medical male circumcision (VMMC) for prevention against HIV. There was no evidence of risk compensation post-circumcision as defined in this study. Significant increases in proportion of participants in the 18-24 years age group who knew the HIV status of their sexual partner (39% to 56%, p = 0.0019), self-reported condom use at last sex act (21% to 34%, p = 0.0106) and those reporting vaginal sexual intercourse in the past 12 months (67% to 79%, p-value = <0.0001) were found. In both 18-24 and 25-40 years age groups, there was a significant increase in perception of being at risk of contracting HIV (70% to 84%, p-value = <0.0001).<h4>Conclusion</h4>No significant risk compensation was observed in this study on comparing pre-and post-circumcision behaviour. An increase in proportion of participants in the 18-24 years age group who had vaginal intercourse in the first 12 months post-circumcision as a possibility of risk compensation was minimal and negated by an increase in proportion of those reporting using a condom at the last sex act, increase in knowledge of partner's HIV status and lack of increase in alcohol post-circumcision.https://doi.org/10.1371/journal.pone.0213571 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hillary Mukudu Janan Dietrich Kennedy Otwombe Mmatsie Manentsa Khuthadzo Hlongwane Maetal Haas-Kogan Benn Sartorius Neil Martinson |
spellingShingle |
Hillary Mukudu Janan Dietrich Kennedy Otwombe Mmatsie Manentsa Khuthadzo Hlongwane Maetal Haas-Kogan Benn Sartorius Neil Martinson Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. PLoS ONE |
author_facet |
Hillary Mukudu Janan Dietrich Kennedy Otwombe Mmatsie Manentsa Khuthadzo Hlongwane Maetal Haas-Kogan Benn Sartorius Neil Martinson |
author_sort |
Hillary Mukudu |
title |
Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. |
title_short |
Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. |
title_full |
Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. |
title_fullStr |
Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. |
title_full_unstemmed |
Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. |
title_sort |
voluntary medical male circumcision (vmmc) for prevention of heterosexual transmission of hiv and risk compensation in adult males in soweto: findings from a programmatic setting. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
<h4>Background</h4>Clinical trials have clearly shown a reduction in HIV acquisition through voluntary medical male circumcision (VMMC). However, data assessing risk compensation under programmatic conditions is limited.<h4>Methods</h4>This was a prospective cohort of HIV seronegative males aged 18-40 years receiving VMMC between November 2012 and July 2014. HIV serostatus was determined pre and post VMMC. Risk compensation was defined as a decrease in condom use at last sex act and/or an increase in concurrent sexual relationships, both measured twelve months post-circumcision.<h4>Results</h4>A total of 233 males were enrolled and underwent voluntary medical male circumcision (VMMC) for prevention against HIV. There was no evidence of risk compensation post-circumcision as defined in this study. Significant increases in proportion of participants in the 18-24 years age group who knew the HIV status of their sexual partner (39% to 56%, p = 0.0019), self-reported condom use at last sex act (21% to 34%, p = 0.0106) and those reporting vaginal sexual intercourse in the past 12 months (67% to 79%, p-value = <0.0001) were found. In both 18-24 and 25-40 years age groups, there was a significant increase in perception of being at risk of contracting HIV (70% to 84%, p-value = <0.0001).<h4>Conclusion</h4>No significant risk compensation was observed in this study on comparing pre-and post-circumcision behaviour. An increase in proportion of participants in the 18-24 years age group who had vaginal intercourse in the first 12 months post-circumcision as a possibility of risk compensation was minimal and negated by an increase in proportion of those reporting using a condom at the last sex act, increase in knowledge of partner's HIV status and lack of increase in alcohol post-circumcision. |
url |
https://doi.org/10.1371/journal.pone.0213571 |
work_keys_str_mv |
AT hillarymukudu voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT janandietrich voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT kennedyotwombe voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT mmatsiemanentsa voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT khuthadzohlongwane voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT maetalhaaskogan voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT bennsartorius voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting AT neilmartinson voluntarymedicalmalecircumcisionvmmcforpreventionofheterosexualtransmissionofhivandriskcompensationinadultmalesinsowetofindingsfromaprogrammaticsetting |
_version_ |
1714805399146725376 |