Evidence of Behavioural Compensation in Internal Replication Study of Male Circumcision Trial to Reduce HIV Acquisition in Kisumu, Kenya

Abstract

We replicated the study ‘Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial’ using an epidemiological approach as well as an econometric approach. Both approaches confirmed the 60 per cent protective effect of circumcision reported in the original paper. Similar to the original paper, we found no evidence of heterogeneous treatment effects by age. Contrary to the original study, we found evidence of risk compensation, with circumcised men less likely to stay abstinent (odds ratio 0.79 [95% CI: 0.64, 0.99]) and more likely to have had unprotected intercourse (OR 1.2 [1.1, 1.4]). These findings reinforce the impact of circumcision but highlight behavioural risk.

Acknowledgements

This work was funded through 3ie’s Replication Window with generous funding from The Bill and Melinda Gates Foundation. All content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors, the 3ie Board of Commissioners, or the Bill and Melinda Gates Foundation. Any errors and omissions are the sole responsibility of the authors.

The authors would like to acknowledge the assistance of Robert C. Bailey, Principal Investigator of the original study, as well as Benjamin Wood, Anna Heard, Annette N. Brown, the anonymous External Project Advisor, and the anonymous external reviewers, who all provided valuable comments on this work.

The data associated with this paper can be purchased from the National Technical Information Service (https://www.ntis.gov). The do files to produce tables presented in the paper can be found at: https://dataverse.harvard.edu/dataset.xhtml?persistentId=doi:10.7910/DVN/5HYL5A.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the International Initiative for Impact Evaluation.