Long-term Effects of Male Circumcision on Risky Sexual Behaviors and STD Infections: Evidence from Malawian Schools
- Long-term Effects of Male Circumcision on Risky Sexual Behaviors and STD Infections: Evidence from Malawian Schools
- Kim, Booyuel
- Issue Date
- Series/Report no.
- Working Paper Series;WP16-08
- The introduction of risk-reducing technology can lead to unintended consequences, especially
when risk compensation can be one of potential operating mechanism to o set the positive
impact. For male circumcision, its preventive e ect against HIV infection might diminish if
circumcised men engage in riskier sexual behaviors. The purpose of this study is to investigate
risk-compensating behavior after medical male circumcision in the long run. We randomly pro-
vided free male circumcision surgery to 2,667 adolescent male students at secondary schools in
Malawi and conducted long-term follow-up survey after about four years. We nd that male
students who received the o er more intensively were 35 percent more likely to be infected
with HSV-2 than the other students, suggesting riskier sexual behavior after circumcision. Self-
reported sexual behavior, meanwhile, are showing little-to-no evidence of practicing riskier sex
after circumcision, except for the inconsistent use of condom.
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