Risk compensation is not associated with male circumcision in Kisumu, Kenya: a multi-faceted assessment of men enrolled in a randomized controlled trial.
Risk compensation is not associated with male circumcision in Kisumu, Kenya: a multi-faceted assessment of men enrolled in a randomized controlled trial.
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风险补偿与肯尼亚Kisumu的男性包皮环切术无关：对参加随机对照试验的男性的多方面评估。
DOI：
10.1371/journal.pone.0002443
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发表时间：
2008-06-18
期刊：
影响因子：
3.7
通讯作者：
Moses, Stephen
中科院分区：
文献类型：
--
作者：
Mattson, Christine L.;Campbell, Richard T.;Bailey, Robert C.;Agot, Kawango;Ndinya-Achola, J. O.;Moses, Stephen
三项随机对照试验（RCT）证实，男性包皮环切术（MC）显着减少艾滋病毒-1感染的男性收购。本研究的目的是进行一项全面的，前瞻性的风险补偿评估，比较包皮环切术与未包皮环切术的对照样本的随机对照试验的参与者。2004年3月至2005年9月，我们系统地招募了在肯尼亚参加MC RCT的男性。采用改良的时间轴随访方法，在基线、6个月和12个月时采集详细的性史。参与者允许从RCT中获得包皮环切状态和实验室结果。我们使用18项风险倾向评分和淋病、衣原体和滴虫病的偶发感染评估了包皮环切术和未包皮环切术男性的性行为。在1780名合格的RCT参与者中，1319名入组（应答率= 74%）。 在基线RCT访视时，参加子研究的男性报告了与未参加子研究的男性相同的性行为。我们发现，从基线到入组后6个月（p<0.01）和12个月（p = 0.05），包皮环切术和未包皮环切术男性的性风险行为显著减少。 纵向分析表明，包皮环切术和未包皮环切术男性之间的性风险倾向评分或淋病、衣原体和滴虫病的偶发感染率无统计学显著差异。这些结果是基于迄今为止对风险补偿的最全面的分析。在随机对照试验的背景下，包皮环切术并没有导致增加艾滋病毒的危险行为。需要继续监测和评估与包皮环切术相关的风险补偿，因为支持其有效性的证据正在传播，MC被广泛推广用于预防艾滋病毒。
Three randomized controlled trials (RCTs) have confirmed that male circumcision (MC) significantly reduces acquisition of HIV-1 infection among men. The objective of this study was to perform a comprehensive, prospective evaluation of risk compensation, comparing circumcised versus uncircumcised controls in a sample of RCT participants. Between March 2004 and September 2005, we systematically recruited men enrolled in a RCT of MC in Kenya. Detailed sexual histories were taken using a modified Timeline Followback approach at baseline, 6, and 12 months. Participants provided permission to obtain circumcision status and laboratory results from the RCT. We evaluated circumcised and uncircumcised men's sexual behavior using an 18-item risk propensity score and acquisition of incident infections of gonorrhea, chlamydia, and trichomoniasis. Of 1780 eligible RCT participants, 1319 enrolled (response rate = 74%). At the baseline RCT visit, men who enrolled in the sub-study reported the same sexual behaviors as men who did not. We found a significant reduction in sexual risk behavior among both circumcised and uncircumcised men from baseline to 6 (p<0.01) and 12 (p = 0.05) months post-enrollment. Longitudinal analyses indicated no statistically significant differences between sexual risk propensity scores or in incident infections of gonorrhea, chlamydia, and trichomoniasis between circumcised and uncircumcised men. These results are based on the most comprehensive analysis of risk compensation yet done. In the context of a RCT, circumcision did not result in increased HIV risk behavior. Continued monitoring and evaluation of risk compensation associated with circumcision is needed as evidence supporting its' efficacy is disseminated and MC is widely promoted for HIV prevention.
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影响因子：
3.1
作者：
Mattson, Christine L.;Bailey, Robert C.;Moses, Stephen
通讯作者：
Moses, Stephen
影响因子：
3.8
作者：
McCoombe, Scott G.;Short, Roger V.
通讯作者：
Short, Roger V.
DOI：
10.1198/016214501753168389
发表时间：
2001-06-01
影响因子：
3.7
作者：
Olsen, MK;Schafer, JL
通讯作者：
Schafer, JL
DOI：
10.1097/01.qai.0000242455.05274.20
发表时间：
2007-01-01
影响因子：
3.6
作者：
Agot, Kawango E.;Kiarie, James N.;Weiss, Noel S.
通讯作者：
Weiss, Noel S.
影响因子：
1.4
作者：
Carey, MP;Carey, KB;Weinhardt, LS
通讯作者：
Weinhardt, LS