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Male Circumcision and HIV Risk Compensation Among Men Who Have Sex with Men: A Systematic Review and Meta-Analysis
Xinsheng Wu1, Zhongwen Wang1, Yongjian Shi1
1School of Public Health, Fudan University, Shanghai, China.
AIDS and Behavior
|August 7, 2025
Summary
Male circumcision (MC) does not lead to increased condomless sex or multiple partners in men who have sex with men (MSM). This study found no association, reinforcing MC as a safe HIV prevention strategy for MSM.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Prevention
Background:
- Male circumcision (MC) is proven to reduce HIV risk in men who have sex with men (MSM).
- A key question is whether MC adoption leads to behavioral compensation, such as increased condomless sex or multiple partners.
Purpose of the Study:
- To investigate the association between male circumcision and sexual risk behaviors (condomless sex, multiple partners) among men who have sex with men.
- To determine if male circumcision leads to HIV risk compensation in this population.
Main Methods:
- A systematic literature review and meta-analysis of interventional and observational studies.
- Searched PubMed, Embase, and Cochrane Library for studies published before November 5, 2024.
- Included 15 studies with data from 41,694 men who have sex with men, using Mantel-Haenszel random effects model.
Main Results:
- No statistically significant association was found between male circumcision and condomless sex (OR 1.02, 95% CI 0.91-1.14).
- No statistically significant association was found between male circumcision and multiple sex partners (OR 1.03, 95% CI 0.94-1.12).
- These findings remained consistent across various subgroup analyses.
Conclusions:
- Male circumcision among men who have sex with men is not associated with increased condomless sex or multiple sex partners.
- Standard HIV prevention service packages should be integrated into MC programs for MSM to maximize protection.
Keywords:
Condomless sexHIV/AIDSMale circumcision (MC)Men who have sex with men (MSM)Multiple sex partnersRisk compensationMore Related Videos
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