Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010–11 Zimbabwe demographic and health survey

BACKGROUND Zimbabwe adopted voluntary medical male circumcision (VMMC) as an additional HIV prevention strategy in 2009. A number of studies have been conducted to understand the determinants of VMMC uptake but few studies have examined the characteristics of men who are willing to get circumcised or the link between wanting circumcision and risky sexual behaviour. This study investigated the relationship between wanting male circumcision and engaging in risky sex behaviours. This was based on the assumption that those who are willing to undergo circumcision are already engaging in risky sexual behaviours. DATA AND METHODS Data from men age 15-45 years who were interviewed during the 2010-11 Zimbabwe Demographic and Health Survey of 2010-11 was used. A total of 7480 men were included in the sample for this study. Logistic regression was used to assess the association between wanting circumcision and risky sexual behaviours. FINDINGS Men in the highest wealth tercile were significantly more likely to want circumcision compared to men in lower wealth terciles (OR=1.36, p<0.01). Wanting circumcision was also significantly associated with age. Men in the 25-34 age category reported wanting circumcision more (OR=1.21, p < 0.05) while older men were significantly less likely to want circumcision (OR=0.63, p<0.01). Christian men and those residing in rural areas were also less likely to want circumcision (OR=0.74, p<0.05 and OR = 0.75, p < 0.001 respectively). The findings of this study indicate a strong association between wanting circumcision and having had risky sex (OR=1.36, p<0.01), having multiple partners (OR=1.35, p<0.01) and having paid for sex (OR=1.42, p < 0.001) However, wanting circumcision was negatively associated with having used a condom at the last risky sex (OR=0.76, p<0.001). CONCLUSIONS The association between demand for VMMC and risky sexual behaviour need continuous monitoring. We emphasise that the promotion of VMMC for HIV prevention should not overshadow the promotion of existing methods of HIV prevention such as condoms and reduction of sexual partners.