Male circumcision and HIV infection among sexually active men in Malawi
Male circumcision and HIV infection among sexually active men in Malawi
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DOI：
10.1186/s12889-015-2384-z
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发表时间：
2015-10-14
影响因子：
4.5
通讯作者：
Jamali, Monica
中科院分区：
文献类型：
--
作者：
Mutombo, Namuunda;Maina, Beatrice;Jamali, Monica
背景：艾滋病毒流行仍然是全世界面临的重大健康挑战。 2013 年，全球估计有 3500 万人感染艾滋病毒。男性包皮环切术越来越多地被采用作为预防艾滋病毒的方法。世界卫生组织和联合国艾滋病规划署建议将男性包皮环切术纳入当前的艾滋病毒干预措施中。马拉维是艾滋病毒/艾滋病最严重的国家之一，2010年的患病率为11%，男性包皮环切率为21.6%。2011年之前，传统的男性包皮环切是马拉维男性包皮环切的主要形式，主要出于文化和宗教原因。本文通过研究马拉维男性中男性包皮环切术与艾滋病毒感染状况之间的关系，将男性包皮环切术作为预防艾滋病毒的方法。方法：所使用的数据是作为 2010 年马拉维人口和健康调查的一部分收集的。马拉维国家统计局和 ICF Macro 已全面描述了 2010 年 MDHS 中使用的方法。我们的分析基于 15-54 岁的男性，他们接受了艾滋病毒检测，并在调查期间回答了有关包皮环切的问题。 MDHS 采访的 7175 名男性中，有 61% 符合此项分析的条件。对样本进行加权以确保代表性。进行了频率、交叉表、单变量和多变量逻辑回归。通过卡方检验确定接受包皮环切和未接受包皮环切的男性中 HIV 感染率的差异。结果：接受包皮环切的男性 (12%) 和未接受包皮环切的男性 (10%) 之间的 HIV 感染率没有显着差异。在接受包皮环切的男性中，年龄和终身伴侣的数量是艾滋病毒感染状况的主要相关因素。此外，与从未进行过性仪式的割过包皮的男性相比，进行过性仪式的割过包皮的男性感染艾滋病毒的可能性是后者的两倍（OR = 2.399）。 结论：这项研究表明，2010 年之前的马拉维，传统的男性包皮环切术与 HIV 感染无关。在接受过包皮环切的男性中，年龄和终生伴侣的数量与艾滋病毒感染状况相关，而接受过包皮环切的男性进行过仪式性行为的男性比接受过包皮环切但未进行过性行为的男性更有可能被诊断为艾滋病毒。
Background: The HIV epidemic remains a major health challenge all over the world. In 2013, an estimated 35million people were living with HIV globally. Male circumcision is increasingly being adopted as a method of HIV prevention. WHO and UNAIDS have advised that male circumcision be added to current HIV interventions. Malawi is one of the countries hardest hit by HIV/AIDS with a prevalence rate of 11 % and male circumcision prevalence of 21.6 % in 2010. Prior to 2011, traditional male circumcision in Malawi was the dominant form of male circumcision, mainly for cultural and religious reasons. This paper looks at male circumcision as a prevention method against HIV by examining the relationship between male circumcision and HIV status among Malawian men.Methods: The data used were collected as part of the 2010 Malawi Demographic and Health Survey. The methodology used in the 2010 MDHS has been comprehensively described by the National Statistical Office of Malawi and ICF Macro. Our analysis is based on men aged 15-54 years who were tested for HIV and responded to questions on circumcision during the survey. Sixty one percent of the 7175 men interviewed in the MDHS, qualified for this analysis. The sample was weighted to ensure representativeness. Frequencies, cross-tabulations, univariate and multivariate logistic regressions were conducted. Differences in the prevalence of HIV infection among circumcised and uncircumcised men were determined with Chi-squared tests.Results: There is no significant difference in HIV prevalence between circumcised (12 %) and uncircumcised men (10 %). Among circumcised men, age and number of lifetime partners are the dominant correlates of HIV status. Additionally, circumcised men who have had ritual sex are two times more likely (OR = 2.399) to be HIV+ compared to circumcised men who have never had ritual sex.Conclusion: This study has demonstrated that traditional male circumcision was not associated with HIV infection in pre-2010 Malawi. Among circumcised men, age and number of lifetime partners are correlates to HIV status while circumcised men who have had ritual sex are more likely to be diagnosed with HIV than circumcised men who have not had ritual sex.