Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
J Sex Med. 2012 Jul;9(7):1904-12. doi: 10.1111/j.1743-6109.2010.02050.x. Epub 2010 Nov 22.
The HIV prevalence among men who have sex with men (MSM) is increasing sharply in China. Many MSM have female sexual partners, representing a bridge of transmitting HIV to the general population. Circumcision reduces the risk of HIV prevention via heterosexual intercourse.
The study investigated the prevalence and factors related to willingness to undergo circumcision when MSM were informed that circumcision could reduce risk of heterosexual HIV transmission.
An anonymous cross-sectional survey was conducted in Jiangsu, China. A total of 157 MSM with bisexual behaviors in the last six months were recruited using snowball sampling.
Self-reported circumcision status and foreskin conditions were recorded. HIV-related knowledge, risk perceptions, risky sexual behaviors, cognitive and behavioral intention factors regarding circumcision were assessed.
Among all respondents, 5.7% were circumcised. In the uncircumcised subsample, the willingness to be circumcised increased from 8.1% to 35.1% after they were informed about the 50% risk reduction effect of circumcision regarding heterosexual HIV transmission. Risk behaviors, uncertainty about the prevalence of HIV among MSM, perception of overly long foreskin, peer's suggestion, disagreement with the statements "MSM in general are not willing to be circumcised" and "circumcisions are for children, not for adults" and self-efficacy for circumcision were significantly associated with willingness for circumcision given the hypothetical risk reduction effect (OR = 2.37 and 3.11, respectively, P < 0.05). Perception of overly long foreskin, self-efficacy, and having used a condom in the last episode of sex with a woman remained significantly associated with the conditional willingness for circumcision in the multivariate analysis (OR = 3.03, 2.84 and 2.42, respectively, P < 0.05).
Interventions promoting circumcision among bisexual MSM, based on the risk reduction effect on heterosexual HIV transmission, are likely to be successful. Such programs should focus on increasing self-efficacy and may consider utilizing a peer educator approach.
中国男男性行为者（MSM）中的艾滋病毒感染率正在急剧上升。许多 MSM 有女性性伴侣，这代表着将艾滋病毒传播给普通人群的桥梁。割礼可以降低通过异性性行为感染艾滋病毒的风险。
本研究旨在调查当 MSM 被告知割礼可以降低异性传播 HIV 的风险时，他们愿意接受割礼的流行率及其相关因素。
采用滚雪球抽样方法，在中国江苏对过去 6 个月有双性性行为的 157 名 MSM 进行了一项匿名横断面调查。
记录自我报告的割礼状况和包皮状况。评估与 HIV 相关的知识、风险认知、高危性行为、关于割礼的认知和行为意向因素。
在所有受访者中，5.7%的人接受了割礼。在未割礼的亚组中，在被告知割礼可降低异性传播 HIV 风险 50%后，愿意割礼的比例从 8.1%增加到 35.1%。风险行为、对 MSM 中 HIV 流行率的不确定性、过长的包皮认知、同伴的建议、不同意“一般来说 MSM 不愿意割礼”和“割礼是为了孩子，不是为了成年人”的观点以及割礼的自我效能感与在假设的风险降低效果下的割礼意愿显著相关（OR=2.37 和 3.11，分别，P<0.05）。在多变量分析中，过长的包皮认知、自我效能感和与女性发生性行为时使用安全套仍然与条件性割礼意愿显著相关（OR=3.03、2.84 和 2.42，分别，P<0.05）。
基于异性传播 HIV 风险降低效果，针对双性恋 MSM 的割礼干预措施可能会取得成功。此类项目应侧重于提高自我效能感，并可能考虑采用同伴教育者方法。
