Circumcision and High-risk Sexual Behavior among Luo Males in Rural Western Kenya

The Luo people of western Kenya have the highest HIV prevalence (20.2%) of any comparable ethnic group in eastern sub-Saharan Africa. In an effort to combat the pandemic, the Kenyan government enacted a scale-up of voluntary male medical circumcision (VMMC) in 2008, using data from three randomized control trials reporting a consistent 60% protective effect from HIV infection for circumcised men as the basis for this expansion. As it so happens, the Luo ethnic group is the only major group that does not traditionally practice circumcision, but present literature indicates that the practice has recently gained some acceptability within the Luo population, primarily in urban areas, as a means of acquiring some protective benefit against HIV infection. This study uses a sample (n=50) of Luo men in rural Nyanza Province to assess how the introduction of VMMC influences high-risk HIV sexual behavior. The effect of VMMC on high-risk sexual behavior is measured using the outcome variables of number of sexual partners and condom usage. Results indicate no statistically significant relationship between male circumcision and condom usage (χ2=0.1164, p=0.7330). The sample, however, does express a dramatic trend in condom usage, revealing that roughly 2/3 of non-condom users are circumcised males. It is also found that male circumcision is a significant predictor for a relatively high number of sexual partners (χ2=11.02, p=0.0009). These results provide insight into just how accurately rural Luo men perceive the protective benefit of circumcision and where current issues with VMMC may need to be addressed in order to attain optimal results for combating HIV incidence.