A prospective cohort study to assess behavioural disinhibition following medical circumcision in youth and adult males in Vulindlela, KwaZulu-Natal
Three RCTs results have provided an impetus to scale up medical circumcision in Sub-Saharan Africa, where male circumcision is not necessarily a traditional practice. Despite encouraging trial results, valid concerns remain about the possibility that male circumcision could lead to increases in high-risk sexual behavior. This issue of sexual disinhibition may be especially relevant for young and sexually active populations in high HIV prevalence areas. Accordingly, this study, using a prospective cohort design, seeks to investigate the effect of medical circumcision on sexual behaviours of school going men, during a 12 month period, post circumcision in a high HIV prevalence district of Vulindlela, in KwaZulu- Natal.
The primary aim of this study is to address the issue of whether the protective effects of medical male circumcision on HIV acquisition are offset by an adverse behavioural impact. Accordingly, this study intends to document young men’s sexual practices over four time points within a 12 month period in a circumcised cohort and over three time points in a non-circumcised cohort. Two cohorts will be tracked over a 12 month period: i) Youth in school cohort of circumcised men, ii) Youth in school cohort of uncircumcised men.
Using a prospective cohort design, the proposed study will enroll a cohort of circumcised (n=500) youth and a cohort of non-circumcised youth (n=400) who are attending schools in Vulindlela School Circuit, KwaZulu Natal, South Africa;. In collaboration with staff at the CAPRISA Vulindlela Research Site (CVRS), youth who consent to be circumcised will be assessed at four time points over a 12 month period (baseline, 6 weeks, 6 months and 12 months). The non-circumcised cohort will be assessed at three time points over a 12 month period (baseline, 6 months and 12 months.) The CVRS will serve as a point for medical circumcision procedure and assessment of behavioural and biomarkers.