Male circumcision and HIV infection in four cities in sub-Saharan Africa
Male circumcision and HIV infection in four cities in sub-Saharan Africa
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撒哈拉以南非洲四个城市的男性包皮环切术和艾滋病毒感染情况
DOI：
10.1097/00002030-200108004-00004
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发表时间：
2001-08-01
期刊：
影响因子：
3.8
通讯作者：
Weiss, HA
中科院分区：
文献类型：
--
作者：
Auvert, B;Buvé, A;Weiss, HA
目的：探讨男性包皮环切术在四个城市人口中的艾滋病毒感染的传播中的作用在撒哈拉以南Africa.Design和Methods：一个横断面的人口为基础的研究进行了在撒哈拉以南非洲的四个城市不同程度的艾滋病毒感染。科托努（贝宁）和雅温得（喀麦隆）的成人艾滋病毒感染率相对较低，基苏穆（肯尼亚）和恩多拉（赞比亚）的感染率超过25%。在每个城市，从一般人口中随机抽取15-49岁的男女样本。研究参与者接受了关于他们的社会人口特征和性行为的采访，并接受了艾滋病毒、单纯疱疹病毒2型、梅毒、淋病和衣原体感染的检测。结果：在科托努和雅温得这两个艾滋病毒感染率较低的城市，99%的男子接受了割礼。在基苏穆，27.5%的男子接受了割礼，在恩多拉，这一比例为9%。在基苏穆，接受包皮环切术的男子艾滋病毒感染率为9.9%，未接受包皮环切术的男子为26.6%。在控制了社会人口特征、性行为和其他性传播感染后，男性包皮环切术的保护作用仍然存在，调整后的比值比为0.26（95%置信区间= 0.12-0.56）。在恩多拉，接受包皮环切术的男子艾滋病毒感染率为25.0%，未接受包皮环切术的男子为26.0%。的权力是不足以调整任何差异性behaviors.Conclusions：艾滋病毒的流行传播的差异可能是由于在性接触以及性行为的差异传播艾滋病毒的概率的差异。男性包皮环切术是影响性交过程中艾滋病毒传播的因素之一，这项研究证实了艾滋病毒和缺乏男性包皮环切术之间的人口水平关联，以及基苏穆，唯一有足够的权力来分析这种关联的城市，一个强大的个人水平的关联。(C)2001年利平科特威廉姆斯&威尔金斯。
Objectives: To explore the role of male circumcision in the spread of HIV infection in four urban populations in sub-Saharan Africa.Design and methods: A cross-sectional population based study was conducted in four cities in sub-Saharan Africa with different levels of HIV infection. HIV prevalence among adults was relatively low in Cotonou (Benin) and in Yaounde (Cameroon), and exceeded 25% in Kisumu (Kenya) and in Ndola (Zambia). In each city, a random sample was taken of men and women aged 15-49 years from the general population. Consenting study participants were interviewed about their sociodemographic characteristics and their sexual behaviour, and were tested for HIV, herpes simplex virus type 2, syphilis, gonorrhoea and chlamydial infection. Men underwent a genital examination.Results: In Cotonou and in Yaounde, the two low HIV prevalence cities, 99% of men were circumcised. In Kisumu 27.5% of men were circumcised, and in Ndola this proportion was 9%. In Kisumu, the prevalence of HIV infection was 9.9% among circumcised men and 26.6% among uncircumcised men. After controlling for socio-demographic characteristics, sexual behaviour and other sexually transmitted infections, the protective effect of male circumcision remained with an adjusted odds ratio of 0.26 (95% confidence interval = 0.12-0.56). In Ndola, the prevalence of HIV infection was 25.0% in circumcised men and 26.0% in uncircumcised men. The power was insufficient to adjust for any differences in sexual behaviour.Conclusions: The differences in epidemic spread of HIV are likely to be due to differences in the probability of transmission of HIV during sexual exposure as well as differences in sexual behaviour. Male circumcision is one of the factors influencing the transmission of HIV during sexual intercourse, and this study confirms the population level association between HIV and lack of male circumcision, as well as a strong individual level association in Kisumu, the only city with sufficient power to analyze this association. (C) 2001 Lippincott Williams & Wilkins.