Acceptability of male circumcision among men who have sex with men in urban China
J. Xu1, G. Mi1, Z. Dou1, E. Liu1, K. Rou1, Z. Wu2, MSM Intervention Trial Group of National Major AIDS Research Project
1National Center for AIDS Control and Prevention, China CDC, Division of Health Education and Behavioral Intervention, Beijing, China, 2National Center for AIDS Control and Prevention, China CDC, Beijing, China
Background: Various studies have indicated that male circumcision can protect about 60% of heterosexual men at risk from HIV infection. However, the effectiveness of this strategy among men who have sex with men (MSM) remains unclear. A community-based trial was designed to evaluate the effectiveness of a comprehensive intervention in which male circumcision is one of the key components among MSM. The objective of this paper is to understand the acceptability of male circumcision among MSM in China using baseline data.
Methods: Six metropolitan cities of China were chosen as the study sites, with four assigned in the intervention group (Shanghai, Guiyang, Chengdu and Nanning) and the other two in the control group (Beijing and Nanning). The intervention will provide free circumcision upon request if appropriate. A modified snowball sampling method was used to recruit approximately 450 MSM at each site between June to September 2009. This modification was based on the fact that level of HIV/STI infection risk is associated with sex partner seeking. Information about demographic characteristics, history and willingness to receive circumcision were collected through face-to-face interviews.
Results: 2,684 eligible MSM were enrolled. The average age of participants was 28.0±8.3 years old. 73.8% were single and 54.0% had a college level education. Based on self-report, 12.1% were already circumcised (no statistical difference between intervention and control groups (13.1% vs 10.5%)). For those uncircumcised in the control group, 33.1% were willing to be circumcised if free service was provided. For those in the intervention group where the circumcision is provided for free, willingness increased to 49.5% when the same question was asked.
Conclusions: The acceptability of male circumcision is higher among uncircumcised MSM when free service is provided. Future interventions involving circumcision should consider the use of free services to encourage more MSM to be circumcised.