Male circumcision and prevention of HIV and sexually transmitted infections.
Male circumcision and prevention of HIV and sexually transmitted infections.
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DOI：
10.1007/s11908-008-0022-y
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发表时间：
2008-05-01
影响因子：
3.1
通讯作者：
Serwadda, David
中科院分区：
文献类型：
--
作者：
Gray, Ronald H;Wawer, Maria J;Serwadda, David
在非洲进行的三项随机试验表明，成年男性包皮环切术可使男性感染艾滋病毒的人数减少约60%。包皮环切术可以降低男性感染艾滋病的风险，这在生物学上是合理的，因为包皮的内粘膜是轻度角化的，并且具有高密度的树突状细胞和其他艾滋病靶细胞，使其易受艾滋病毒感染。此外，在性交过程中，包皮在性交轴上收缩，使内部粘膜暴露于阴道分泌物；包皮在性交过程中很容易受到创伤，为艾滋病毒提供了一个入口。此外，包皮环切术降低了报告的生殖器溃疡率，这是艾滋病毒感染的一个辅助因素。男性包皮环切术也可以减少男性及其女性伴侣的其他一些性传播感染。由于这些原因，男性包皮环切应作为艾滋病毒预防战略的一个组成部分加以促进。
Three randomized trials in Africa have shown that adult male circumcision reduces HIV acquisition in men by approximately 60%. It is biologically plausible that circumcision reduces HIV risk in men because the inner mucosa of the foreskin is lightly keratinized and has a high density of dendritic cells and other HIV target cells, making it vulnerable to HIV infection. Also, the foreskin is retracted over the shaft during intercourse, exposing the inner mucosa to vaginal secretions; the prepuce is vulnerable to trauma during coitus, providing a portal for HIV entry. In addition, circumcision reduces the rate of reported genital ulceration, which is a cofactor for HIV acquisition. Male circumcision may also reduce some other sexually transmitted infections in men and their female partners. For these reasons, male circumcision should be promoted as a component of HIV prevention strategies.