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Circumcision Among Men Who Have Sex With Men in London, United Kingdom: An Unlikely Strategy for HIV Prevention

Thornton, Alicia C. MSc*; Lattimore, Samuel PhD*; Delpech, Valerie MBBS*; Weiss, Helen A. PhD; Elford, Jonathan PhD

doi: 10.1097/OLQ.0b013e318221562a
Original Study

Objectives: To explore attitudes toward circumcision among men who have sex with men (MSM) in London and the feasibility of conducting research into circumcision and HIV prevention in this population.

Methods: A convenience sample of MSM visiting central London gyms completed a confidential, self-administered questionnaire between May and June 2008. Information was collected on participants' demographic characteristics, self-reported HIV status, sexual behavior, circumcision status, attitudes toward circumcision, and willingness to participate in research on circumcision and HIV prevention.

Results: Of 653 MSM, 29.0% reported that they were circumcised. Overall, HIV prevalence was 23.3%; this did not differ significantly between circumcised and uncircumcised men (18.6% vs. 25.2%, respectively; adjusted odds ratio 0.79, 95% confidence interval: 0.50–1.26). A similar proportion of circumcised and uncircumcised men reported unprotected anal intercourse in the previous 3 months (38.8% vs. 36.7%, adjusted odds ratio 1.06, 95% confidence interval: 0.72–1.55). Uncircumcised men were less likely to think that there were benefits of circumcision than circumcised men (31.2% vs. 65.4, P < 0.001). Only 10.3% of uncircumcised men said that they would be willing to participate in research on circumcision as an HIV prevention strategy.

Conclusions: Most uncircumcised MSM in this London survey were unwilling to participate in research on circumcision and HIV prevention. Only a minority of uncircumcised men thought that there were benefits of circumcision. It is unlikely that circumcision would be a feasible strategy for HIV prevention among MSM in London.

Research among men who have sex with men in London, United Kingdom, suggests that circumcision is unlikely to be a feasible strategy for HIV prevention in this population.

From the *Health Protection Agency, Centre for Infections, London, United Kingdom; †Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom; and ‡Department of Public Health, City University, London, United Kingdom

The authors thank the managers and members of the gyms for their support and participation in the project and all those who distributed and collected questionnaires.

Supported by Health Protection Agency and Camden and Islington Health Authority and Primary Care Trusts.

Correspondence: Jonathan Elford, Department of Public Health, City University, 20 Bartholomew Close, London EC1A 7QN, United Kingdom. E-mail: j.elford@city.ac.uk.

Received for publication February 9, 2011, and accepted April 25, 2011.

© Copyright 2011 American Sexually Transmitted Diseases Association