Circumcision and HIV acquisition risk among men who have sex with men (MSM) in Buenos Aires, Argentina.

PANDO MA; MARONE R; BALAN I; DOLEZAL C; BARREDA V; CARBALLO DIEGUEZ A; AVILA MM

Bangkok

Conferencia; AIDS Vaccine 2011; 2011

Background: Several studies have demonstrated that circumcision reduces HIV acquisition among heterosexual men by approximately 60%.However, this may not be the case among MSM who engage in receptive anal intercourse (RAI).In Argentina, no information has been available about frequency of circumcision among MSM or its potential benefits.That was the focus of the present study. Methods: 500 MSM recruited through RDS (respondent-driven-sampling) for an HIV-prevalence study were asked if they were circumcised and, if not, whether they would be interested in circumcision if it could protect them against HIV. Inclusion criteria included age at least 18 years, resident of Buenos Aires, reporting sex with men at least 10 times in their lives and at least once in the past six months. All statistics have been weighted based on the participants’ self-reported network size.  Results: A total of 66 (14%) MSM reported being circumcised. No statistical differences were observed on age, condom-use, or sexual role (receptive or insertive with a man) between circumcised and uncircumcised. HIV prevalence was 17%. Being circumcised was not significantly associated with HIV prevalence (p=0.211). Stratifying the group according to their sexual role, 36% reported engaging in RAI. Among those who do not practice RAI, those who were circumcised (N= 37) had no cases of HIV infection, whereas among those who were uncircumcised, 15% (40 of 265) were HIV positive (p=0.007). No difference in HIV prevalence was observed between circumcised and uncircumcised among those who practice RAI. Among those who were not circumcised, 75% said that they would not be willing to be circumcised even if it could be beneficial for HIV infection risk reduction.     Conclusions: Further exploration is required on the potentially protective role that circumcision may have for MSM who refrain from RAI. Attention should be paid to the lack of motivation of MSM to be circumcised for HIV prevention.