Willingness of men who have sex with men (MSM) in the United States to be circumcised as adults to reduce the risk of HIV infection.
BACKGROUND
Circumcision reduces HIV acquisition among heterosexual men in Africa, but it is unclear if circumcision may reduce HIV acquisition among men who have sex with men (MSM) in the United States, or whether MSM would be willing to be circumcised if recommended.


METHODS
We interviewed presumed-HIV negative MSM at gay pride events in 2006. We asked uncircumcised respondents about willingness to be circumcised if it were proven to reduce risk of HIV among MSM and perceived barriers to circumcision. Multivariate logistic regression was used to identify covariates associated with willingness to be circumcised.


RESULTS
Of 780 MSM, 133 (17%) were uncircumcised. Of these, 71 (53%) were willing to be circumcised. Willingness was associated with black race (exact odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.3-9.8), non-injection drug use (OR: 6.1, 95% CI: 1.8-23.7) and perceived reduced risk of penile cancer (OR: 4.7, 95% CI: 2.0-11.9). The most commonly endorsed concerns about circumcision were post-surgical pain and wound infection.


CONCLUSIONS
Over half of uncircumcised MSM, especially black MSM, expressed willingness to be circumcised. Perceived risks and benefits of circumcision should be a part of educational materials if circumcision is recommended for MSM in the United States.
Begley
Elin B
EB
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. EQB5@cdc.gov
Jafa
Krishna
K
Voetsch
Andrew C
AC
Heffelfinger
James D
JD
Borkowf
Craig B
CB
Sullivan
Patrick S
PS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002944:Circumcision, Male / Q000523:psychology* / Q000706:statistics & numerical data; D015658:HIV Infections / Q000517:prevention & control*; D006716:Homosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012309:Risk-Taking; D012725:Sexual Behavior; D011795:Surveys and Questionnaires