Abstract
BackgroundMale circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference.MethodsA cross-sectional survey was conducted between September 2009 and December 2010. We interviewed 2,219 male community participants, from three high HIV prevalence provinces in western China. A structured questionnaire was used to collect data on MC knowledge, willingness to accept MC, reasons to accept or refuse MC, and sexual behaviors and health. For those who refused MC, a health education intervention providing information on the benefits of circumcision was conducted. We used multiple logistic regression models to identify factors associated with the acceptability of MC.ResultsOf the respondents (n = 2,219), 44.6% (989/2,219) reported they would accept MC for the following reasons: promotion of female partners' hygiene (60.3%), redundant foreskin (59.4%), prevention of penile cancer (50.2%), enhanced sexual pleasure (41.4%), and protection against HIV and STDs (34.2%). The multivariable logistic regression showed that five factors were associated with MC willingness: long foreskin (OR = 15.98), residing in Xinjiang province (OR = 3.69), being younger than 25 (OR = 1.60), knowing hazards of redundant foreskin (OR = 1.78), and having a friend who underwent circumcision (OR = 1.36).ConclusionThe acceptability of male circumcision was high among the general population in China. Our study elucidates the factors associated with circumcision preference and suggests that more health education campaigns about positive health effects are necessary to increase the MC rate in China.
Highlights
Randomized controlled trials (RCTs) in Africa have shown that male circumcision (MC) can reduce the risk of human immunodeficiency virus (HIV) infection by 50% to 60% in heterosexual men [1,2,3]
The AIDS epidemic is mainly concentrated in six provinces where the number of people with HIV/AIDS accounts for 83.0% of the total HIV/AIDS population: Yunnan, Guangxi, Henan, Xinjiang, Guangdong, and Sichuan
In this study we explored the acceptability of Male circumcision (MC) and documented the factors associated with circumcision preference among Chinese residents in Western China
Summary
Randomized controlled trials (RCTs) in Africa have shown that male circumcision (MC) can reduce the risk of HIV infection by 50% to 60% in heterosexual men [1,2,3]. The AIDS epidemic is mainly concentrated in six provinces where the number of people with HIV/AIDS accounts for 83.0% of the total HIV/AIDS population: Yunnan, Guangxi, Henan, Xinjiang, Guangdong, and Sichuan. Four of these high HIV prevalence provinces are located in western China [9] where poverty is widespread, knowledge and risk perception of HIV are low, and unprotected commercial sexual encounters are common [11]. In Guangxi province, heterosexual transmission accounted for 60.9% of the reported HIV cases in 2009, followed by IDU (31.6%), MSM (0.8%), and others (6.7%). The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference
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