On 2014 Mar 26, Gwinyai Masukume commented:

The authors write, “With respect to the concern that men might engage in riskier sexual behavior after circumcision, data from the three RCTs1–3 and a prospective cohort study8 found no overall increases in risk behavior following circumcision.”

In the abstract of the first RCT it is written, “When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%).” Auvert B, 2005

In the abstract of a meta-analysis of the three RCTs it is written, “For the South African trial [the first RCT] the mean number of sexual contacts at the 12-month visit was 5.9 in the circumcision group versus 5 in the control group, which was a statistically significant difference (p < 0.001). This difference remained statistically significant at the 21-month visit (7.5 versus 6.4; p = 0.0015).” Siegfried N, 2009

One can then conclude that in the first RCT men engaged in riskier sexual behavior after circumcision. The authors appear to downplay risk compensation i.e. men engaging in riskier sexual behavior after circumcision.

In the abstract of the next paper that the authors cite (9), it is written, “In the context of a RCT [not the first RCT but one of the three], circumcision did not result in increased HIV risk behavior. Continued monitoring and evaluation of risk compensation associated with circumcision is needed as evidence supporting its' efficacy is disseminated and MC is widely promoted for HIV prevention.” Mattson CL, 2008

Apparently downplaying risk compensation seems curious since continued monitoring and evaluation is needed.

RCT - Randomized Controlled Trial

On 2014 Mar 26, Gwinyai Masukume commented:

The authors write, “With respect to the concern that men might engage in riskier sexual behavior after circumcision, data from the three RCTs1–3 and a prospective cohort study8 found no overall increases in risk behavior following circumcision.”

In the abstract of the first RCT it is written, “When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%).” Auvert B, 2005

In the abstract of a meta-analysis of the three RCTs it is written, “For the South African trial [the first RCT] the mean number of sexual contacts at the 12-month visit was 5.9 in the circumcision group versus 5 in the control group, which was a statistically significant difference (p < 0.001). This difference remained statistically significant at the 21-month visit (7.5 versus 6.4; p = 0.0015).” Siegfried N, 2009

One can then conclude that in the first RCT men engaged in riskier sexual behavior after circumcision. The authors appear to downplay risk compensation i.e. men engaging in riskier sexual behavior after circumcision.

In the abstract of the next paper that the authors cite (9), it is written, “In the context of a RCT [not the first RCT but one of the three], circumcision did not result in increased HIV risk behavior. Continued monitoring and evaluation of risk compensation associated with circumcision is needed as evidence supporting its' efficacy is disseminated and MC is widely promoted for HIV prevention.” Mattson CL, 2008

Apparently downplaying risk compensation seems curious since continued monitoring and evaluation is needed.

RCT - Randomized Controlled Trial