中国的HIV流行现状非常严峻，而男性性病患者是HIV感染和传播的关键人群。包皮环切作为WHO和UNAIDS推荐的循证HIV生物医学预防手段，尚未应用于该人群中。在前期研究的基础上，本课题组将招募广东省4个大中城市中800名男性性病患者，进行第一阶段横断面研究，探讨计划行为理论对包皮环切手术意向，以及健康行为过程理论对风险补偿行为意向（意图在接受包皮环切后与女性发生无保护的性行为）的解释能力。我们将根据其结果设计用于第二阶段咨询的视频。在第二阶段随机对照试验中, 500名患者将被随机分入对照组（简单书面宣教材料）和实验组（性病诊疗经验丰富的医生利用视频进行咨询）。我们将比较第三和第六个月随访时两组的包皮环切率和相关风险补偿行为意向, 通过观察中介效应，分析改变包皮环切率和风险补偿行为意向的机制。该研究成果可为在广东省以至全国男性性病患者中大规模推广包皮环切预防HIV和性病感染提供科学依据。

The HIV and sexually transmitted diseases (STD) epidemics are severe in China. Male circumcision is a newly developed, yet under-utilized, evidence-based HIV prevention for heterosexual males, which is recommended by WHO and UNAIDS. Despite the significance, there is no published study on implementation of male circumcision among male STD patients, a high risk population bridging HIV transmission from high risk populations to low risk populations. A two-phase study is proposed, targeting male STD patients of four cities in Guangdong Province. Phase I is a cross-sectional study (n=800). The Theory of Planned Behavior (TPB) and motivational phase the Health Action Process Approach (HAPA) will be used as the conceptual frameworks to investigate factors of intention to take up circumcision and factors of risk compensation intention. Risk compensation is defined as intention to have unprotected sex after taking up male circumcision. In Phase II, a counseling program will be designed, using a video based on the Phase I results (experimental group) and evaluate its effects using a randomized controlled study against a control group (simple printed pamphlet). The experimental health promotion counseling aims at changing the cognitive constructs of TPB and HAPA, and to evaluate whether such cognitive changes would result in differences in actual circumcision rate (primary outcome) and intention for risk compensation behavior (secondary outcome) between the experimental group and the control group. The Phase II results allow us to understand the mechanisms behind the differences in changes related to male circumcision between the experimental and control groups. Furthermore, the findings will provide evidence for scaling up male circumcision for HIV/STD prevention in Guangdong and nationwide.