Male circumcision in Siaya and Bondo Districts, Kenya - Prospective cohort study to assess behavioral disinhibition following circumcision
Male circumcision in Siaya and Bondo Districts, Kenya - Prospective cohort study to assess behavioral disinhibition following circumcision
复制标题
DOI：
10.1097/01.qai.0000242455.05274.20
复制
发表时间：
2007-01-01
影响因子：
3.6
通讯作者：
Weiss, Noel S.
中科院分区：
文献类型：
--
作者：
Agot, Kawango E.;Kiarie, James N.;Weiss, Noel S.
背景：越来越多的证据表明男性包皮环切术作为艾滋病毒预防措施的有效性，但人们严重担心接受包皮环切术的男性随后可能会采取更危险的性行为。方法：通过一项前瞻性队列研究，我们比较了 324 名最近接受包皮环切术的男性和 324 名未接受包皮环切术的男性在包皮环切术/研究入组后 1、3、6、9 和 12 个月的性行为。主要结果指标是已知会增加男性感染艾滋病毒风险的性行为发生率，即已婚男性与妻子以外的伴侣发生性关系，未婚男性则与“正式”女友以外的伴侣发生性行为。 结果：在割礼后的第一个月内，与未割包皮的男性相比，男性每周报告有 0 至 0.5 次和 > 0.5 次危险性行为的可能性分别要低 63% 和 61%。这种差异在剩余的随访期间消失了，接受包皮环切的男性中没有发生过多的危险性行为。在危险的无保护性行为、危险性伴侣的数量和安全套的使用方面也观察到了类似的结果。讨论：在包皮环切术后的第一年，男性并没有比未受包皮环切的男性进行更多危险的性行为，这表明男性包皮环切对艾滋病毒感染的任何保护作用不太可能被不良行为影响所抵消。
Background: Evidence for efficacy of male circumcision as an HIV prevention measure is increasing, but there is serious concern that men who are circumcised may subsequently adopt more risky sexual behaviors.Methods: Using a prospective cohort study, we compared sexual behaviors of 324 recently circumcised and 324 uncircumcised men at 1, 3, 6, 9, and 12 months after circumcision/study enrollment. The main outcome indicators were incidence of sexual behaviors known to place men at increased risk of acquiring HIV, namely, having sex with partners other than their wife/wives for married men or other than "regular" girlfriends for unmarried men.Results: During the first month following circumcision, men were 63% and 61% less likely to report having 0 to 0.5 and > 0.5 risky sex acts/week, respectively, than men who remained uncircumcised. This difference disappeared during the remainder of follow-up, with no excess of reported risky sex acts among circumcised men. Similar results were observed for risky unprotected sex acts, number of risky sex partners, and condom use.Discussion: During the first year postcircumcision, men did not engage in more risky sexual behaviors than uncircumcised men, suggesting that any protective effect of male circumcision on HIV acquisition is unlikely to be offset by an adverse behavioral impact.