Male Circumcision and Risky Sexual Behavior in a High HIV Prevalence Country: Evidence from a National Survey in Uganda

Simon P. S. Kibira, Makerere University
Elizabeth Nansubuga, Makerere University
Nazarius Tumwesigye, Makerere University
Frederick Makumbi, Makerere University
Lynn M. Atuyambe, Makerere University
Helen Nviiri, Uganda Bureau of Statistics

Safe Male Circumcision is a known intervention in prevention of heterosexual HIV acquisition. However, since the roll-out of the male circumcision policy in Uganda, concerns that circumcision may lead to behavior disinhibition are rife. We assess the association between male circumcision, risky sexual behavior and HIV status among Ugandan men. Data are from AIDS Indicator Survey 2011 with 7,969 ever sexually active men aged 15-59 years. The prevalence of circumcision was 28% and most common risky sexual behaviors were; multiple life-time sexual partners, non marital sex and non-use of condoms. Adjusted logistic regression analyses showed that multiple life-time partners, OR=1.47 (95%CI: 1.28-1.68), engagement in non marital sex, OR=1.25 (95%CI: 1.03-1.50), and non-use of condom at such sex were significantly higher among the circumcised. HIV prevalence was lower among the circumcised even with risky sexual behaviors. There is need for continued sensitization on circumcision and re-packaging of the circumcision messages.