Article Text

Download PDFPDF

Circumcision among men who have sex with men in Scotland: limited potential for HIV prevention
  1. Lisa M McDaid1,
  2. Helen A Weiss2,
  3. Graham J Hart
  1. 1MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
  2. 2MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London, UK
  1. Correspondence to Dr Lisa M McDaid, MRC/CSO Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, UK; l.mcdaid{at}sphsu.mrc.ac.uk

Abstract

Objective Male circumcision has been shown to reduce the risk of HIV acquisition among heterosexual men but the impact among men who have sex with men (MSM) is not known. In this paper, we explore the feasibility of research into circumcision for HIV prevention among MSM in Scotland.

Methods Anonymous, self-complete questionnaires and Orasure oral fluid collection kits were distributed to men visiting the commercial gay scenes in Glasgow and Edinburgh.

Results 1508 men completed questionnaires (70.5% response rate) and 1277 provided oral fluid samples (59.7% response rate). Overall, 1405 men were eligible for inclusion in the analyses. 16.6% reported having been circumcised. HIV prevalence was similar among circumcised and uncircumcised men (4.2% and 4.6%, respectively). Although biologically, circumcision is most likely to protect against HIV for men practising unprotected insertive anal intercourse (UIAI), only 7.8% (91/1172) of uncircumcised men reported exclusive UIAI in the past 12 months. Relatively few men reported being willing to participate in a research study on circumcision and HIV prevention (13.9%), and only 11.3% of uncircumcised men did so.

Conclusion The lack of association between circumcision and HIV status, low levels of exclusive UIAI, and low levels of willingness to take part in circumcision research studies suggest circumcision is unlikely to be a feasible HIV prevention strategy for MSM in the UK. Behaviour change should continue to be the focus of HIV prevention in this population.

  • Circumcision
  • gay men
  • HIV
  • men who have sex with men
  • sexual behaviour
  • unprotected anal intercourse

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Funding The UK Medical Research Council funds LMMcD and the Gay Men's Survey as part of the Sexual and Reproductive Health Programme (WBS U.1300.00.005) at the Social and Public Health Sciences Unit, and funds HAW as part of the MRC Tropical Epidemiology Group.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Glasgow Faculty of Medicine Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.