Circumcision and STD in the United States: cross sectional and cohort analyses
Circumcision and STD in the United States: cross sectional and cohort analyses
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DOI：
10.1136/sti.76.6.474
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发表时间：
2000-12-01
影响因子：
3.6
通讯作者：
Iatesta, M
中科院分区：
文献类型：
--
作者：
Diseker, RA;Peterman, TA;Iatesta, M
背景资料：男性包皮环切术状态已被证明与性传播疾病（STD）的收购在一些，但不是所有的研究。大多数研究都是cross-section.Objectives：我们研究了包皮环切术的地位和淋病，衣原体，和syphily.Methods的患病率和发病率之间的关联：我们分析了横截面和队列研究数据在美国的多中心对照试验。1993年7月至1996年9月，2021名男性访问公共内城性病诊所在美国进行了检查，由临床医生在登记和1456人进行了检查，在后续访问6个月和12个月后。每次就诊时，男性都要进行淋病、衣原体和梅毒的实验室检查，并检查包皮环切情况。我们使用多元逻辑回归来比较包皮环切术和未包皮环切术男性之间的STD风险，调整了潜在的混杂因素。结果：在多变量分析中，未包皮环切术男性比包皮环切术男性更容易患淋病，调整了年龄，种族和部位，在横断面和横断面中，（比值比（OR），1.3; 95%置信区间（CI），0.9 re，1.7）和队列分析（OR，1.6; 95% CI，1.0至2.6）。在横断面（OR，1.0; 95%CI 0.7-1.4）或队列分析（OR，0.9; 95%CI 0.5-1.5）中，未行包皮环切术与衣原体感染之间无关联。缺乏包皮环切术和梅毒之间的关联程度是相似的横截面（OR，1.4; 95%CI 0.6至3.3）和队列分析（OR，1.5; 95%CI 0.4至6.1）。结论：在美国未行包皮环切术的男性可能会增加淋病和梅毒的风险，但衣原体感染的风险似乎在包皮环切术和未行包皮环切术的男性相似。我们的研究结果表明，横断面研究的风险估计与队列研究结果相似。
Background: Male circumcision status has been shown to be associated with sexually transmitted disease (STD) acquisition in some, but not all, studies. Most studies have been cross sectional.Objectives: We examined the association between circumcision status and the prevalence and incidence of gonorrhoea, chlamydia, and syphilis.Methods: We analysed cross sectional and cohort study data from a multicentre controlled trial in the United States. Between July 1993 and September 1996, 2021 men visiting public inner city STD clinics in the United States were examined by a clinician at enrolment and 1456 were examined at follow up visits 6 and 12 months later. At each visit, men had laboratory tests for gonorrhoea, chlamydia, and syphilis and were examined for circumcision status. We used multiple logisitic regression ro compare STD risk among circumcised and uncircumcised men adjusted for potentially confounding factors.Results: Uncircumcised men were significantly more likely than circumcised men to have gonorrhoea in the multivariate analyses, adjusted for age, race, and site, in both the cross sectional (odds ratio (OR), 1.3; 95% confidence interval (CI), 0.9 re, 1.7) and in the cohort analysis (OR, 1.6; 95% CI, 1.0 to 2.6). There was no association between lack of circumcision and chlamydia in either the cross sectional (OR, 1.0; 95% CI 0.7-1.4) or the cohort analysis (OR, 0.9; 95% CI 0.5-1.5). The magnitude of association between lack of circumcision and syphilis was similar in the cross sectional (OR, 1.4; 95% CI 0.6 to 3.3) and cohort analysis (OR, 1.5; 95% CI 0.4 to 6.1).Conclusion: Uncircumcised men in the United States may be at increased risk for gonorrhoea and syphilis, but chlamydia risk appears similar in circumcised and uncircumcised men. Our results suggest that risk estimates from cross sectional studies would be similar to cohort findings.