Sexual risk behaviors following circumcision among HIV-positive men in Rakai, Uganda.
Sexual risk behaviors following circumcision among HIV-positive men in Rakai, Uganda.
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DOI：
10.1080/09540121.2018.1437253
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发表时间：
2018-08
期刊：
影响因子：
1.7
通讯作者：
Gray R
中科院分区：
文献类型：
--
作者：
Kankaka EN;Ssekasanvu J;Prodger J;Nabukalu D;Nakawooya H;Ndyanabo A;Kigozi G;Gray R
确定艾滋病毒阳性男性的包皮环切术是否与随后的性危险行为增加有关，这些行为可能使其女性伴侣面临风险。 Rakai 社区队列研究中新割礼和未割礼的 HIV 阳性男性从基线（2013 年 7 月至 2015 年 1 月）进行了随访，以确定性危险行为的趋势以及随访时（2015 年 2 月至 2016 年 9 月）包皮环切与后续性危险行为的关联。危险行为包括性活动、性行为前饮酒、性交易、多个性伴侣、临时性伴侣以及与临时性伴侣不一致地使用安全套。使用改进的泊松回归评估关联性，并在使用链式方程对缺失数据进行多重插补后进行敏感性分析。我们确定了 538 名符合条件的男性，其中 113 人（21.0%）在基线时接受过包皮环切术，425 人（79.0%）未接受包皮环切术。渔业社区的男性以及那些接触有针对性的艾滋病毒信息的男性更有可能接受包皮环切术 (p=0.032) (p<0.001)。总体而言，188 名（34.9%）男性失访，其中大多数未接受包皮环切术（p=0.020）。在随访者中，行为基本保持不变，没有因包皮环切状况而存在差异。在未调整分析（PR=1.58，95%CI=1.01,2.48；p=0.045，p=0.05）和调整分析（adj.PR=1.54，95%CI=1.06,2.23；p=0.022）中，性交易似乎与包皮环切术相关。然而，在考虑失访后，敏感性分析中的相关性不再显着（adj.PR=1.43，95%CI=0.98,2.08；p=0.066）。没有观察到其他性危险行为与包皮环切术之间的关联。我们发现艾滋病毒阳性男性的包皮环切术与随后的危险性行为之间没有关联。
To determine whether circumcision of HIV-positive men is associated with increased subsequent sexual risk behaviors which may place their female partners at risk. Newly circumcised and uncircumcised HIV-positive men in the Rakai Community Cohort Study were followed from baseline (July 2013-January 2015) to determine trend in sexual risk behaviors and association of circumcision with subsequent sexual risk behaviors at follow up (February 2015-September 2016). Risk behaviors included sexual activity, alcohol before sex, transactional sex, multiple sex partners, casual sex partners, and inconsistent condom use with casual partners. The association was evaluated using modified Poisson regression, and sensitivity analyses were performed after multiple imputation with chained equations for missing data. We identified 538 eligible men, of whom 113(21.0%) were circumcised at baseline and 425(79.0%) were uncircumcised. Men in fishing communities were more likely to be circumcised (p=0.032) as well as those exposed to targeted HIV messaging (p<0.001). Overall, 188(34.9%) men were lost to follow up and most were uncircumcised (p=0.020). Among those followed up, behaviors remained largely unchanged with no differences by circumcision status. Transactional sex appeared to be associated with circumcision in unadjusted analyses (PR=1.58, 95%CI=1.01,2.48; p=0.045, p=0.05) and adjusted analyses (adj.PR=1.54, 95%CI=1.06,2.23; p=0.022). However, the association was no longer significant in sensitivity analyses after accounting for loss to follow up (adj.PR=1.43, 95%CI=0.98,2.08; , p=0.066). No association with circumcision was observed for other sexual risk behaviors. We found no association between circumcision of HIV-positive men and subsequent sexual risk behavior.
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影响因子：
3.7
作者：
Awad, Susanne F.;Sgaier, Sema K.;Abu-Raddad, Laith J.
通讯作者：
Abu-Raddad, Laith J.
DOI：
10.1056/nejmoa1702150
发表时间：
2017-11-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Grabowski MK;Serwadda DM;Gray RH;Nakigozi G;Kigozi G;Kagaayi J;Ssekubugu R;Nalugoda F;Lessler J;Lutalo T;Galiwango RM;Makumbi F;Kong X;Kabatesi D;Alamo ST;Wiersma S;Sewankambo NK;Tobian AAR;Laeyendecker O;Quinn TC;Reynolds SJ;Wawer MJ;Chang LW;Rakai Health Sciences Program
通讯作者：
Rakai Health Sciences Program
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影响因子：
3.7
作者：
Mattson, Christine L.;Campbell, Richard T.;Bailey, Robert C.;Agot, Kawango;Ndinya-Achola, J. O.;Moses, Stephen
通讯作者：
Moses, Stephen
影响因子：
3.7
作者：
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通讯作者：
Sandoy, Ingvild Fossgard
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DOI：
10.1080/09540121.2016.1178696
发表时间：
2016-10-01
影响因子：
1.7
作者：
Wang, Zixin;Feng, Tiejian;Lau, Joseph T. F.
通讯作者：
Lau, Joseph T. F.