Perceptions of Risk and Sexual Behavior Change Following Adult Male Circumcision in Urban Swaziland

Jonathan Grund, Emory University
Monique M. Hennink, Emory University

Male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomized controlled trials. However, little is known about the sexual behavior change of men who have been circumcised and whether the protective effect of circumcision leads to riskier sexual behavior among circumcised men. This study uses qualitative in-depth interviews to understand men’s sexual behavior after circumcision. Men in urban Swaziland, circumcised in the last 12 months, were recruited and asked about their perceptions of sexual risk, and sexual behavior post-circumcision. Although behavioral disinhibition was investigated, results show that men report greater sexual responsibility and sexual satisfaction after the procedure. Results also indicate that HIV counseling and testing may act as a barrier to men seeking circumcision, which reinforces the need for consistent messaging supporting HIV counseling and testing practices with male circumcision scale-up.