The recent finding that circumcision reduces the likelihood of HIV infection has led to many discussions about how circumcision might be a viable prevention strategy for reducing the spread of HIV. However, the roll-out and scaling up of services in Africa has been slow. This study aims to address two main concerns of scaling up circumcision service delivery in the context of the first nation-wide roll-out of male circumcision services in Malawi. First, how can a program best mitigate potential negative responses to male circumcision in terms of risky sexual behavior and 2) what are the best ways ? through targeting and subsidies ? to increase the take-up of male circumcision in a sustainable way.