The introduction of risk-reducing technology can lead to unintended consequences, especially
when risk compensation can be one of potential operating mechanism to offset the positive
impact. For male circumcision, its preventive effect against HIV infection might diminish if
circumcised men engage in riskier sexual behaviors. The purpose of this study is to investigate
risk-compensating behavior after medical male circumcision in the long run. We randomly provided
free male circumcision surgery to 2,667 adolescent male students at secondary schools in
Malawi and conducted long-term follow-up survey after about four years. We find that male
students who received the offer more intensively were 35 percent more likely to be infected
with HSV-2 than the other students, suggesting riskier sexual behavior after circumcision. Selfreported
sexual behavior, meanwhile, are showing little-to-no evidence of practicing riskier sex
after circumcision, except for the inconsistent use of condom.