Skip to main content
Article thumbnail
Location of Repository

Is Sex Like Driving? Risk Compensation Associated with Male Circumcision in Kisumu, Kenya

By Nicholas Wilson, Wentao Xiong and Christine Mattson


Mass adult male circumcision campaigns for HIV prevention are underway across much of Sub-Saharan Africa. However, concern remains about risk compensation associated with the reduction in the probability of HIV transmission per risky act. This paper examines the be- havioral response to male circumcision in Kisumu, Kenya. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision reduces fatalism about acquiring HIV/AIDS and increases the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient's belief about the reduction in the risk of acquiring HIV.HIV/AIDS, male circumcision, risk compensation, beliefs, Kenya

OAI identifier:

Suggested articles


  1. (2005). Acceptability of male circumcision and predictors of circumcision preference among men and women in Nyanza Province,
  2. (2007). Acceptability of male circumcision for prevention of HIV/AIDS in Sub-Saharan Africa: A review.
  3. (2009). Adult Male Circumcision Does Not Reduce the Risk of Incident Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis Infection: Results from a Randomized, Controlled Trial in Kenya. The Journal of Infectious Diseases,
  4. (2006). An exploration of the oset hypothesis using disaggregate data: The case of airbags and antilock brakes.
  5. (2001). and the Rakai Project Team.
  6. (2009). Bill Gates helps fund mass circumcision programme. New Scientist,
  7. (2008). Circumcision and risk of sexually transmitted infections in a birth cohort.
  8. (2009). Circumcision in HIV-infected men and its eect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trial.
  9. (1997). Circumcision in the United States: prevalence, prophylactic eects, and sexual practice.
  10. (2011). Circumcision preference among women and uncircumcised men prior to scale-up of male circumcision for HIV prevention in Kisumu,
  11. (2008). Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men.
  12. (2009). Eect of male circumcision on the prevalence of high-risk human papillomavirus in young men: Results of a randomized controlled trial conducted in Orange Farm, South Africa.
  13. (1997). Genetic risk factors and osetting behavior: The case of skin cancer.
  14. (1990). Geographical patterns of male circumcision practices in Africa: Association with HIV seroprevalence.
  15. (1994). Highway safety, economic behavior, and driving environment.
  16. (2009). HIV and sexual behavior change: Why not Africa?
  17. (2009). Male circumcision and risk of HIV 22infection in women: a systematic review and meta-analysis. The Lancet, Infectious Diseases,
  18. (2000). Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. AIDS
  19. (2006). Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis. Sexually Transmitted Infections,
  20. (2007). Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial.
  21. (2007). Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. The Lancet,
  22. (2009). Male circumcision for the prevention of HSV-2 and HPV infections and syphilis.
  23. (2003). Male circumcision in Britain: from a national probability sample survey.
  24. (2007). Male circumcision in Siaya and Bondo Districts, Kenya: prospective cohort study to assess behavioral disinhibition following circumcision.
  25. (2007). Male Circumcision, Global Trends and Determinants of Prevalence, Safety, and Acceptability. World Health Organiztion.
  26. (1998). Male circumcision: assessment of health bene and risks.
  27. (2009). Progress in Male Circumcision Scale-up: Country Implementation Update.
  28. (2005). Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 Trial.
  29. (2005). Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. The Journal of Infectious Diseases,
  30. (2008). Risk compensation is not associated with male circumcision in Kisumu, Kenya: A multi-faceted assessment of men enrolled in a randomized controlled trial.
  31. (2006). Risk compensation: the Achilles heel of innovations in HIV prevention?
  32. (1991). Risk reduction or risk compensation? The case of mandatory safety belt use laws.
  33. (1975). The eects of automobile safety regulation.
  34. (1989). The relationship between male circumcision and HIV infection in African populations.
  35. (2011). Will circumcision provide even more protection from HIV to women and men? New estimates of the population impact of circumcision interventions.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.