Impact of male circumcision on HIV risk compensation through the impediment of condom use in Botswana.
BACKGROUND
Male circumcision has been recommended as a method of reducing the risk of transmitting HIV. However, widespread uptake of male circumcision may lead to HIV risk compensation by impeding condom use.


OBJECTIVE
To investigate the impact of male circumcision on condom use.


METHODS
The study used cross-sectional data from the Botswana AIDS Impact Survey III on 1,257 men aged 15 years or older who were sexually active. Data were analyzed using Pearson's chi-square statistic and binary logistic regression.


RESULTS
The study found that 15% of circumcised men did not use condoms compared to 12% of uncircumcised men, and circumcision was not significantly associated with condom use. Non-use of condoms was significantly affected by religious beliefs, low level of education, marriage, drunkenness, and misconceptions regarding antiretroviral therapy (ART).


CONCLUSIONS
We conclude that male circumcision does not impede condom use. Condom use is impeded by low level of education, marriage, drunkenness, and misconceptions regarding ART. We recommend the emphasis of consistent condom use targeting people with low education, those in marriage, users of alcohol, and people receiving ART.
Population Training and Research Unit, North West University Mafikeng Campus, Private Bag x2046, Mmabatho 2735, South Africa. natalayiga@yahoo.com
N
N
Ayiga
G
G
Letamo
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001902:Botswana; D002944:Circumcision, Male; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult