Male circumcision and risky sexual behaviour amongst youths aged 15-24 years in Zambia

Abstract

Research evidence suggests that male circumcision is perceived in some areas as protective against Human Immune Virus (HIV) infection, and has even been referred to as the “invisible condom.” Such perceptions of protection may lead to increased risk behaviours, including reduced condom use. The aim of this study is to establish the association between Male Circumcision on risky sexual behaviour amongst Zambian young people aged 15-24 years. The study was based on secondary data from the Zambia Demographic and Health Survey 2013/14 and a cross-sectional study design was adopted with reference to the nature of the ZDHS. Three level analyses were employed using STATA version 13.0. Descriptive analysis was done at the first level whilst chi-square tests were employed to measure association between dependent and independent variables at second level. A multivariate ordinal regression was used estimate odds ratios (OR) and 95% confidence intervals (CIs) with level of risky sexual behaviour as the outcome variable and age at circumcision, reason for circumcision and the circumciser as independent variables. The study findings show that the most common reason for circumcision amongst the young people is treatment of diseases (17.3 %); further premarital sex and condom use are significantly associated with the respondents’ circumcision status. In addition, youths circumcised at the age 15 to 19 years old are 0.36 times less likely to engage in higher risky sexual behaviour compared to their counter parts circumcised below the age of 5 years (95% CI:0.15-0.88, P-value:<0.001). According to the findings, Youths that were circumcised by the traditional circumcisers were 2.4 times (p-value 0.015) much more likely to engage in high sexual risky behaviours compared to those circumcised by a health personnel (95% CI:1.18-4.94, P-value<0.015). The study concluded that male circumcision is associated with low use condoms and youth’s engagement in premarital sex. In addition, reasons for circumcision, age at circumcision and the circumciser are strongly associated with moderate to high risky sexual behaviour.