How Willing are Men Who Have Sex with Men in China to Be Circumcised for the Sake of Protecting His Female Sex Partner?

Abstract

Introduction 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. Aim 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. Methods 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. Main Outcome Measures 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. Results 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). Conclusions 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.

Acceptability of Voluntary Medical Male Circumcision (VMMC) among Male Sexually Transmitted Diseases Patients (MSTDP) in China

“…We found that 12% of the sampled MSTDP were circumcised at the time of survey. Such prevalence is comparable with that of other studies conducted in China [ 19 , 24 , 42 ]. It is much lower than that of the U.S., Republic of Korea and Philippines [ 17 ].…”

HIV Prevalence Trends, Risky Behaviours, and Governmental and Community Responses to the Epidemic among Men Who Have Sex with Men in China

“…It is estimated that less than 5% of the total male Chinese population are circumcised [385]. However, 30.7–36.4% of MSM are willing to undergo circumcision [291, 386, 387]. Second, HIV preexposure prophylaxis (PrEP) may reduce the chance of HIV acquisition during sexual intercourse [388].…”

Gay Saunas and the Risks of HIV and Syphilis Transmissions in China—Results of a Meta-Analysis

“…Many of the surveys targeting MSM collected data from gay venues or via the Internet [11–17]. Some of these studies focused on methodological issues concerning the relationships between venue type and the study results [11,13,15].…”