Details

Autor(en) / Beteiligte

• GRAY, Ronald H
• KIWANUKA, Noah
• CHEN, Michael Z
• LI, Chuanjun
• WAWER, Maria J
• QUINN, Thomas C
• SEWANKAMBO, Nelson K
• SERWADDA, David
• MANGEN, Fred Wabwire
• LUTALO, Tom
• NALUGODA, Fred
• KELLY, Robert
• MEEHAN, Mary

Titel

Male circumcision and HIV acquisition and transmission : cohort studies in Rakai, Uganda

Ist Teil von

• AIDS (London), 2000-10, Vol.14 (15), p.2371-2381

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins

Erscheinungsjahr

2000

Quelle

EZB-FREE-00999 freely available EZB journals

Beschreibungen/Notizen

• Studies whether male circumcision is associated with reduced HIV acquisition. HIV acquisition was determined in a cohort of 5,507 HIV-negative Ugandan men, & in 187 HIV-negative men in discordant relationships. Transmission was determined in 223 HIV-positive men with HIV-negative partners. HIV incidence per 100 person years (py) & adjusted rate ratios (RR) & 95% confidence intervals (CI) were estimated by Poisson regression. HIV-1 serum viral load was determined for the seropositive partners in HIV-discordant couples. The prevalence of circumcision was 16.5% for all men; 99.1% in Muslims & 3.7% in non-Muslims. Circumcision was significantly associated with reduced HIV acquisition in the cohort as a whole (RR 0.53, CI 0.33-0.87), but not among non-Muslim men. Prepubertal circumcision significantly reduced HIV acquisition (RR 0.49, CI 0.26-0.82), but postpubertal circumcision did not. In discordant couples with HIV-negative men, no seroconversions occurred in 50 circumcised men, whereas HIV acquisition was 16.7 per 100 py in uncircumcised men (P = 0.004). In couples with HIV-positive men, HIV transmission was significantly reduced in circumcised men with HIV viral loads less than 50 000 copies/ml (P = 0.02). Prepubertal circumcision may reduce male HIV acquisition in a general population, but the protective effects are confounded by cultural & behavioral factors in Muslims. In discordant couples, circumcision reduces HIV acquisition & transmission. The assessment of circumcision for HIV prevention is complex & requires randomized trials. 5 Tables, 21 References. Adapted from the source document.