Learning that circumcision is protective against HIV: Risk compensation among men and women in Cape Town, South Africa

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dc.creatorMaughan-Brown, Brendan
dc.creatorVenkataramani, Atheendar
dc.date2014-07-01T09:58:15Z
dc.date2014-07-01T09:58:15Z
dc.date2012
dc.date.accessioned2012-07-19T10:06:45Z
dc.date.available2012-07-19T10:06:45Z
dc.date.issued2012-07-19
dc.description.abstractObjectives: We examined whether knowledge of the HIV-protective benefits of male circumcision (MC) led to risk compensating behavior in a traditionally circumcising population in South Africa. We extend the current literature by examining risk compensation among women, which has hitherto been unexplored. Methods: We used data on Xhosa men and women from the 2009 Cape Area Panel Study. Respondents were asked if they had heard that MC reduces a man’s risk of contracting HIV, about their perceived risk of contracting HIV, and condom use. For each gender group we assessed whether risk perception and condom use differed by knowledge of the protective benefits of MC using bivariate and then multivariate models controlling for demographic characteristics, HIV knowledge/beliefs, and previous sexual behaviors. In a further check for confounding, we used data from the 2005 wave to assess whether individuals who would eventually become informed about the protective benefits of circumcision were already different in terms of HIV risk perception and condom use. Results: 34% of men (n = 453) and 27% of women (n = 690) had heard that circumcision reduces a man’s risk of HIV infection. Informed men perceived slightly higher risk of contracting HIV and were more likely to use condoms at last sex (p<0.10). Informed women perceived lower HIV risk (p<0.05), were less likely to use condoms both at last sex (p<0.10) and more generally (p<0.01), and more likely to forego condoms with partners of positive or unknown serostatus (p<0.01). The results were robust to covariate adjustment, excluding people living with HIV, and accounting for risk perceptions and condom use in 2005. Conclusions: We find evidence consistent with risk compensation among women but not men. Further attention should be paid to the role of new information regarding MC, and drivers of HIV risk more broadly, in modulating sexual behavior among women.
dc.identifier.citationMaughan-Brown, B. & Venkataramani, A. (2012). Learning that circumcision is protective against HIV: Risk compensation among men and women in Cape Town, South Africa, PLoS ONE, 7(7): 1-9.
dc.identifier.ris TY - Journal Article AB - Objectives: We examined whether knowledge of the HIV-protective benefits of male circumcision (MC) led to risk compensating behavior in a traditionally circumcising population in South Africa. We extend the current literature by examining risk compensation among women, which has hitherto been unexplored. Methods: We used data on Xhosa men and women from the 2009 Cape Area Panel Study. Respondents were asked if they had heard that MC reduces a man’s risk of contracting HIV, about their perceived risk of contracting HIV, and condom use. For each gender group we assessed whether risk perception and condom use differed by knowledge of the protective benefits of MC using bivariate and then multivariate models controlling for demographic characteristics, HIV knowledge/beliefs, and previous sexual behaviors. In a further check for confounding, we used data from the 2005 wave to assess whether individuals who would eventually become informed about the protective benefits of circumcision were already different in terms of HIV risk perception and condom use. Results: 34% of men (n = 453) and 27% of women (n = 690) had heard that circumcision reduces a man’s risk of HIV infection. Informed men perceived slightly higher risk of contracting HIV and were more likely to use condoms at last sex (p<0.10). Informed women perceived lower HIV risk (p<0.05), were less likely to use condoms both at last sex (p<0.10) and more generally (p<0.01), and more likely to forego condoms with partners of positive or unknown serostatus (p<0.01). The results were robust to covariate adjustment, excluding people living with HIV, and accounting for risk perceptions and condom use in 2005. Conclusions: We find evidence consistent with risk compensation among women but not men. Further attention should be paid to the role of new information regarding MC, and drivers of HIV risk more broadly, in modulating sexual behavior among women. DA - 2012-07-19 DB - OpenUCT DO - 10.1371/journal.pone.0040753 DP - University of Cape Town J1 - PLoS ONE KW - HIV/AIDS KW - Male circumcision KW - Risk compensation KW - Traditional circumcision KW - CAPS KW - Xhosa men LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Learning that circumcision is protective against HIV: Risk compensation among men and women in Cape Town, South Africa TI - Learning that circumcision is protective against HIV: Risk compensation among men and women in Cape Town, South Africa UR - http://hdl.handle.net/11090/760 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11090/760
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0040753
dc.languageen
dc.publisherPLoS ONE
dc.publisher.departmentSALDRUen_ZA
dc.publisher.facultyFaculty of Commerceen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourcePLoS ONE
dc.source.urihttp://www.plosone.org/
dc.subjectHIV/AIDS
dc.subjectMale circumcision
dc.subjectRisk compensation
dc.subjectTraditional circumcision
dc.subjectCAPS
dc.subjectXhosa men
dc.titleLearning that circumcision is protective against HIV: Risk compensation among men and women in Cape Town, South Africa
dc.typeJournal Article
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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