Risk Compensation in Voluntary Medical Male Circumcision Programs.

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES

Current HIV/AIDS Reports Pub Date : 2022-12-01 DOI:10.1007/s11904-022-00635-9

Yanxiao Gao, Yinghui Sun, Weiran Zheng, Yi-Fan Lin, Tian Tian, Yuwei Li, Leiwen Fu, Huachun Zou

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引用次数: 1

Abstract

Purpose of review: Evidence from clinical trials identified the effectiveness of voluntary medical male circumcision (VMMC) as an additional strategy to reduce the risk of HIV transmission from women to men. However, concerns about post-circumcision sexual risk compensation may hinder the scale-up of VMMC programs. We reviewed the evidence of changes in risky sexual behaviors after circumcision, including condomless sex, multiple sex partners, and early resumption of sex after surgery.

Recent findings: Most clinical trial data indicate that condomless sex and multiple partners did not increase for men after circumcision, and early resumption of sex is rare. Only one post-trial surveillance reports that some circumcised men had more sex partners after surgery, but this did not offset the effect of VMMC. Conversely, qualitative studies report that a small number of circumcised men had increased risky sexual behaviors, and community-based research reports that more men resumed sex early after surgery. With the large-scale promotion and expansion of VMMC services, it may be challenging to maintain effective sexual health educations due to various restrictions. Misunderstandings of the effect of VMMC in preventing HIV infection are the main reason for increasing risky sexual behaviors after surgery. Systematic and practical sexual health counseling services should be in place on an ongoing basis to maximize the effect of VMMC.

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自愿医疗男性包皮环切项目的风险补偿。

审查目的:来自临床试验的证据确定了自愿医疗男性包皮环切术(VMMC)作为减少女性向男性传播艾滋病毒风险的额外战略的有效性。然而，对包皮环切术后性风险补偿的担忧可能会阻碍VMMC项目的扩大。我们回顾了包皮环切术后危险性行为改变的证据，包括无套性行为、多性伴侣和术后早期恢复性行为。最近的发现:大多数临床试验数据表明，包皮环切术后男性无套性行为和多性伴侣的数量并没有增加，早期恢复性生活的情况也很少见。只有一项试验后监测报告称，一些割包皮的男性在手术后有更多的性伴侣，但这并不能抵消VMMC的影响。相反，定性研究报告称，少数接受过包皮环切手术的男性危险性行为增加，社区研究报告称，更多男性在手术后较早恢复性生活。随着性保健服务的大规模推广和扩展，由于各种限制，维持有效的性健康教育可能是一项挑战。对VMMC预防HIV感染效果的误解是术后危险性行为增加的主要原因。系统和实用的性健康咨询服务应该在持续的基础上到位，以最大限度地发挥VMMC的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.