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Background: We conducted a cluster randomised trial to evaluate an intervention to increase VMMC uptake among men aged 20-34 years in Tabora and Njombe regions, Tanzania. Findings showed that the intervention increased the uptake of VMMC in men for all age groups in the 10 intervention clusters compared to the 10 control clusters. The aim of this sub-study was to compare the behaviour risk profile of a sample of the VMMC clients to that of uncircumcised men in the general population in Tanzania.
Methods: Approximately 20% of the VMMC clients aged 20-34 years participating in the study were randomly selected to complete an interviewer-administered questionnaire which addressed risk behaviour, user costs, and decision-making around VMMC. The behaviour parameters were compared with similar parameters collected in the last DHS survey (2010) from uncircumcised men in the 12 VMMC priority regions in Tanzania.
Results: A total of 331 men aged 20-34 years participated in the sexual behaviour survey, and 195 in the 2010 DHS. VMMC clients were younger than the DHS participants, and after adjusting for age, they were more likely to report two or more sexual partners (adjusted OR=2·73, 95%CI 1.85-4.02;
p< 0.001), and to report unprotected sex with non-marital and non-cohabiting partners in the past 12 months (adjusted OR=1·81, 95%CI 1·12-2·93; p=0·003). The mean age at first intercourse was 17.7 years in the behavioural survey participants and 16.7 years among DHS participants (age adjusted test of significance p< 0.001).
Conclusions: Men who accepted VMMC reported more risky sexual behaviour compared to men in the general population. These findings suggest that VMMC is reaching men at a relatively high risk of HIV, and increasing uptake of VMMC through demand creation activities in adult men will continue to reduce HIV acquisition and transmission.

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