Acceptability of male circumcision for HIV prevention among men who have sex with men in China: a short report

ABSTRACT

Recent evidence shows that circumcision is associated with lower HIV prevalence among MSM. We assessed the acceptability of circumcision for preventing HIV and that of Shang Ring circumcision (SRC) among men who have sex with men (MSM) in China. 538 adult MSM were recruited from six cities in China between January and March 2019. Participants were surveyed by an online, self-administered questionnaire. The acceptability of circumcision was assessed before and after the potential protective effect of circumcision against HIV was informed, and subsequently men’s willingness to undergo SRC was assessed. The level of circumcision was 16.4%. Of 450 uncircumcised MSM, their willingness to be circumcised in the following six months increased significantly from 32.2% to 55.6% after the information session. Three quarters of men who were willing to undergo circumcision accepted SRC. MSM who perceived that circumcision could maintain genital hygiene were more likely to accept circumcision after the information session, whereas those who regarded circumcision as an embarrassing surgery were disinclined to be circumcised. The low circumcision rate, along with its high acceptability in Chinese MSM, suggests a great potential benefit of circumcision intervention if proved effective. SRC might be a popular circumcision procedure in this population.

KEYWORDS:

• Men who have sex with men
• circumcision
• Shang Ring
• HIV
• acceptability

Acknowledgements

We thank all the study participants and staff members of our study sites. TY, YG, WZ, RH, PL, and HZ designed the study and collected the data. XM, KZ, GW, YZ, DL, YC, SF, LO, JZ, MY recruited participants and collected the data. TY analyzed the data and made the tables and figures with suggestions from HQ. TY and YG wrote the first draft with the input from HZ, HQ, JW and HZ. JW provided statistical consultation. HQ and HZ edited the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the Natural Science Foundation of China Excellent Young Scientists Fund [grant number 82022064], Natural Science Foundation of China International/Regional Research Collaboration Project [grant number 72061137001], Natural Science Foundation of China Young Scientist Fund [grant number 81703278], the Australian National Health and Medical Research Commission (NHMRC) Early Career Fellowship [grant number APP1092621], the National Science and Technology Major Project of China [grant number 2018ZX10721102], the Sanming Project of Medicine in Shenzhen [grant number SZSM201811071], the High Level Project of Medicine in Longhua, Shenzhen [grant number HLPM201907020105], the National Key Research and Development Program of China [grant number 2020YFC0840900] and the Fundamental Research Funds for the Central Universities [grant number 58000-31620005].