Evidence of Behavioural Compensation in Internal Replication Study of Male Circumcision Trial to Reduce HIV Acquisition in Kisumu, Kenya
复制了肯尼亚男性包皮环切术预防HIV的随机对照试验，确认了60%的保护效果，但发现包皮环切男性更可能发生无保护性行为，存在风险补偿行为。
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.