Assessment of the Protective Effect of Male Circumcision from HIV Infection and Sexually Transmitted Diseases: Evidence from 18 Demographic and Health Surveys in Sub-Saharan Africa
),
(1) Hawassa University, Addis Ababa, Ethiopia.
Corresponding Author
Abstract
A cross-sectional study based on the secondary data of 18 Demographic Health Surveys carried out in Sub-Saharan Africa was conducted to assess the protective effect of male circumcision from HIV infection and STDs. Information on 70,554 males aged 15-59 years was extracted. The association between circumcision and HIV infection and STD symptoms (Genital discharge or ulcer/sore) was assessed using logistic regression. Un-circumcision was significantly associated with risk of HIV with odds ratio of 4.12 (95%CI: 3.85-4.42). The association was even more significant, 4.95 (95%CI: 4.575.36), after adjustment was made for number lifetime sexual partners and socio-demographic variables. The risk associated with un-circumcision is significantly lower among younger men aged 15-29 years than older age categories. However, circumcision found to have no association with the symptoms of STDs. The study concluded that male circumcision can be considered as a way of reducing the spread of HIV infection (Afr. J. Reprod. Health 2010; 14[2]: 105-113).
RĖSUMĖ
Evaluation de l’effet protecteur de la circumcision contre l’infection du VIH et des maladies sexuellement transmissibles : Evidence tirée à partir des 18 enquêtes démographiques et sanitaires en Afrique sub – saharéenne. Une étude transversale basée sur les données secondaires portant sur les 18 Enquêtes de la Santé Démographique qui a été menée en Afrique sub–saharéenne a été effectuée pour évaluer l’effet protecteur de la circoncision du mâle contre le VIH et les MSTs. Nous avons collecté des informations sur 70554 mâles âgés de 15 – 59. A l’aide de la régression logistique, nous avons évalué l’association entre la circoncision et l’infection du VIH et les symptômes des MSTs (l’écoulement génital ou l’ulcère/la plaie). L’incirconcision a été associée, considérablement au risque du VIH ayant un indice de cote de 4,12 (95% CI : 385 – 4,42). L’association a été encore plus significative, 4,95 (95% CI :4,57 – 5,36), après avoir effectué une modification sur le nombre de partenaires sexuels à vie et les variables socio-démographiques. Le risque lié à l’incirconcision est considérablement moins chez les hommes plus jeunes, âgés de 15 – 29 que chez les plus âgés. Néanmoins, on a trouvé que la circoncision n’est pas liée aux symptômes des MSTs. Comme conclusion, l’étude affirme que la circoncision peut être considérée comme un moyen de réduire la propagation de l’infection du VIH (Afr. J. Reprod. Health 2010; 14[2]: 105-113).
KEYWORDS: Circumcision, HIV infection, Sexually Transmitted Infections.
References
UNAIDS/WHO. AIDS in Sub Saharan Africa: 2007 update. July 2008.
Weiss HA, Halperin D, Bailey RC, Hayes RJ, Schmid G and Hankins CA. Male circumcision for HIV prevention: from evidence to action. AIDS 2008; 22: 567-74.
CIRP. Circumcision and HIV infection. Retrieved Aug 07, 2009, from http://www.cirp.org/library/disease /HIV/.
CDC. CDC HIV/AIDS science facts: Male circumcision and risk for HIV transmission and other health conditions: Implications for the United States. Retrieved Aug 07, 2009, from http://www.cdc.gov/hiv/resources/factsheets/pdf/ circumcision.
Howe RV. Circumcision and HIV infection: Review of the literature and meta-analysis. Int. J. STD AIDS 1999; 10: 8-16.
Moses S, Brandly JE, Nagelkerke JD, Ronald AR, Ndinya-Achola JO and Plummer FA. Geographical patterns of male circumcision practices in Africa: Association with HIV sero-prevalence. Intl. J. Epidemiol. 1990; 19: 693-7.
Weiss HA, Quigley MA and Hayes RJ. Male circumcision and risk of HIV infection in SubSaharan Africa: A systematic review and metaanalysis. J AIDS 2000; 14: 2361-70.
Auvert B, Taljaard D, Lagarde E, Tambekou JS, Sitta R and Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med 2005; 2: 298.
Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya:
A randomized controlled trial. J Lancet 2007;
: 643-56.
Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized trial. J. Lancet 2007; 369: 657-66.
Carael M, Van de Perre PH, Lepage PH, Allen S, Nsengumuremyi F, Van Goethem C, et al. Human immunodeficiency virus transmission among heterosexual couples in central Africa. J AIDS 1988; 2: 201–5.
Grosskurth H, Mosha F, Todd J, Mwijarubi E, Klokke A, Senkoro K, et al. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania. J. AIDS 1995; 9: 927–34.
Barongo LR, Borgdorff MW, Mosha FF. Nicoll A, Grosskurth H, Senkoro KP, The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza region, Tanzania. J. AIDS 1992; 6: 1521–8.
Weiss HA, Thomas SL, Munabi SK and Hayes
RJ. Male circumcision and risk of Syphilis, Chancroid, and Genital Herpes: A systematic review and meta-analysis. Sex Transm Infect 2006; 82: 101-10.
Fergusson DM, Boden JM and Horwood LJ. Circumcision status and risk of sexually transmitted infection in young adult males: An analysis of a longitudinal birth cohort. J. Pediatr. 2006; 118: 1971-7.
Reynolds SJ, Shepherd ME, Risbud AR, Gangakhedkar RR, Brookmeyer RS, Divekar AD, Male circumcision and risk of HIV-1 and other sexually transmitted infections in India. J. Lancet 2004; 363: 1039-40.
Dickson NP. Circumcision and risk of sexually transmitted infections in a birth cohort. J. Pediatr. 2008; 152: 383-7.
Donovan B, Bassett I and Bodsworth NJ. Male circumcision and common sexually transmissible diseases in a developed nation setting. J. Genitourin Med. 1994; 70: 317-20.
Lavreys L, Rakwar JP, Thompson ML, Jackson DJ, Mandaliya K, Chohan BH, Effect of circumcision on incidence of human immunedeficiency virus type 1 and other sexually transmitted diseases: A prospective cohort study of trucking company employees in Kenya. J. Infect. Dis. 1999; 180: 330–6.
Tobian AA, Serwadda D, Quinn TC, Kigozi G, Gravitt PE, Laeyendecker O, Male circumcision for the prevention of HSV-2 and HPV infections and Syphilis. N. Engl. J. Med. 2009; 360: 1298309.
Smith GL, Greenup R and Takafuji ET. Circumcision as a risk factor for Urethritis in racial groups. Am. J. Public Health 1987; 77: 452-4.
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