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1996-03-04
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Document 0740
DOCN M9640740
TI Male circumcision, sexually transmitted disease, and risk of HIV.
DT 9604
AU Seed J; Allen S; Mertens T; Hudes E; Serufilira A; Carael M; Karita E;
Van de Perre P; Nsengumuremyi F; Projet San Francisco, California, USA.
SO J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;8(1):83-90.
Unique Identifier : AIDSLINE MED/96142205
AB Our objective was to describe associations among male circumcision,
behavioral and demographic variables, ulcerative and nonulcerative
sexually transmitted disease (STD), and human immunodeficiency virus
(HIV) infection via a cross-sectional study in Kigali, the capital of
Rwanda. Our subjects were 837 married men who volunteered for HIV
testing and counselling. Uncircumcised men had a relatively low-risk
profile in that they reported fewer lifetime sexual partners and
prostitute contacts than circumcised men and were more likely to live in
rural areas with lower HIV prevalence rates. Uncircumcised men were also
less likely to report a history of sexually transmitted disease (64%
versus 73%, p = 0.01), although they were more likely to report genital
ulceration (GUD) (24% versus 17%, p < 0.03) and to have inguinal
adenopathy noted on physical exam (42% versus 29%, p = 0.009). Despite
the low-risk profile, uncircumcised men had a higher prevalence of HIV
infection than circumcised men (29% versus 21% HIV positive, p = 0.02),
which was most marked in men reporting five or more lifetime sex
partners (36% versus 23% HIV positive, p = 0.005) or contact with
prostitutes (35% versus 23% HIV positive, p = 0.009). Circumcision
remained a predictor of HIV infection in multivariate analyses
(multivariate odds ratio 1.69, 95% confidence interval 1.16-2.47). Lack
of circumcision is associated with a higher risk of HIV infection in
Rwandan men. Further research is needed to determine whether this higher
risk is due in part to poor hygiene or to complex mechanisms operating
through the acquisition of other sexually transmitted diseases.
Circumcision may be an appropriate risk reduction approach for men with
known exposures to the virus when there are constraints to alternatives,
such as condom use.
DE Adult *Circumcision Cross-Sectional Studies Demography Genital
Diseases, Male/EPIDEMIOLOGY Human HIV Infections/*EPIDEMIOLOGY Male
Multivariate Analysis Prevalence Prospective Studies Risk Factors
Rwanda/EPIDEMIOLOGY Sex Behavior/STATISTICS & NUMER DATA Sexually
Transmitted Diseases/*EPIDEMIOLOGY Support, U.S. Gov't, P.H.S. JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).