Foreskin surface area and HIV acquisition in Rakai, Uganda (size matters).
Foreskin surface area and HIV acquisition in Rakai, Uganda (size matters).
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DOI：
10.1097/qad.0b013e328330eda8
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发表时间：
2009-10-23
期刊：
影响因子：
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通讯作者：
Gray RH
中科院分区：
文献类型：
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作者：
Kigozi G;Wawer M;Ssettuba A;Kagaayi J;Nalugoda F;Watya S;Mangen FW;Kiwanuka N;Bacon MC;Lutalo T;Serwadda D;Gray RH
男性包皮环切术减少了男性感染艾滋病毒。我们评估包皮表面积是否与包皮环切术前HIV感染有关。在两项男性包皮环切术的随机试验中，使用标准化程序在手术后测量包皮的表面积。965名最初HIV阴性的男性被纳入一个社区队列，随后被纳入男性包皮环切术试验，在包皮环切术前提供了3920.8人-年的观察。我们估计了包皮环切术前每100人-年的HIV发病率，并将包皮表面积分为四分位数。平均包皮表面积显着高于男性感染艾滋病毒（43.3平方厘米，标准误差2.1）与男性谁仍然未感染（36.8平方厘米，标准误差0.5，P = 0.01）。艾滋病毒感染率为0.80/100人-年包皮表面积处于最低四分位数的男性（8/994.9人年）（≤26.3 cm 2），0.92/100人-年（9/975.3人-年），包皮面积在第二四分位数（26.4-35.0平方厘米），0.90/100人-年（8/888.5人-年），包皮面积在第三四分位数（35.2-45.5 cm 2）和2.48/100人-年（23/926.8人-年）的男性包皮表面积在最高四分位数（>45.6 cm 2）。与包皮表面积处于最低四分位数的男性相比，包皮表面积处于最大四分位数的男性的HIV感染校正发病率比值为2.37（95%置信区间1.05-5.31）。包皮表面积较大的男性感染艾滋病毒的风险增加。
Male circumcision reduces HIV acquisition in men. We assessed whether foreskin surface area was associated with HIV acquisition prior to circumcision. In two randomized trials of male circumcision, the surface area of the foreskin was measured after surgery using standardized procedures. Nine hundred and sixty-five initially HIV-negative men were enrolled in a community cohort who subsequently enrolled in the male circumcision trials, provided 3920.8 person-years of observation prior to circumcision. We estimated HIV incidence per 100 person-years prior to circumcision, associated with foreskin surface area categorized into quartiles. Mean foreskin surface area was significantly higher among men who acquired HIV (43.3 cm2, standard error 2.1) compared with men who remained uninfected (36.8 cm2, standard error 0.5, P = 0.01). HIV incidence was 0.80/100 person-years (8/994.9 person-years) for men with foreskin surface areas in the lowest quartile ( ≤26.3 cm2), 0.92/100 person-years (9/975.3 person-years) with foreskin areas in the second quartile (26.4–35.0 cm2), 0.90/100 person-years (8/888.5 person-years) with foreskin area in the third quartile (35.2–45.5 cm2) and 2.48/100 person-years (23/926.8 person-years) in men with foreskin surfaces areas in the highest quartile (>45.6 cm2). Compared with men with foreskin surface areas in the lowest quartile, the adjusted incidence rate ratio of HIV acquisition was 2.37 (95% confidence interval 1.05–5.31) in men with the largest quartile of foreskin surface area. The risk of male HIV acquisition is increased among men with larger foreskin surface areas.