title: Male circumcision in Siaya and Bondo Districts, Kenya: prospective cohort study to assess behavioral disinhibition following circumcision.
abstract: BACKGROUND
  Evidence for efficacy of male circumcision as an HIV prevention measure is increasing, but there is serious concern that men who are circumcised may subsequently adopt more risky sexual behaviors.
  
  
  METHODS
  Using a prospective cohort study, we compared sexual behaviors of 324 recently circumcised and 324 uncircumcised men at 1, 3, 6, 9, and 12 months after circumcision/study enrollment. The main outcome indicators were incidence of sexual behaviors known to place men at increased risk of acquiring HIV, namely, having sex with partners other than their wife/wives for married men or other than "regular" girlfriends for unmarried men.
  
  
  RESULTS
  During the first month following circumcision, men were 63% and 61% less likely to report having 0 to 0.5 and >0.5 risky sex acts/week, respectively, than men who remained uncircumcised. This difference disappeared during the remainder of follow-up, with no excess of reported risky sex acts among circumcised men. Similar results were observed for risky unprotected sex acts, number of risky sex partners, and condom use.
  
  
  CONCLUSIONS
  During the first year post-circumcision, men did not engage in more risky sexual behaviors than uncircumcised men, suggesting that any protective effect of male circumcision on HIV acquisition is unlikely to be offset by an adverse behavioral impact.
authors.affiliation: Research and Development Organization, Kisumu, Kenya. kawango@unimkenya.org
authors.forename: Kawango E
authors.initials: KE
authors.lastname: Agot
authors.forename: James N
authors.initials: JN
authors.lastname: Kiarie
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: Nguyen
authors.forename: Jacob O
authors.initials: JO
authors.lastname: Odhiambo
authors.forename: Tom M
authors.initials: TM
authors.lastname: Onyango
authors.forename: Noel S
authors.initials: NS
authors.lastname: Weiss
mesh_terms: D000328:Adult; D002944:Circumcision, Male; D015331:Cohort Studies; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D017533:Marital Status; D011446:Prospective Studies; D012725:Sexual Behavior