Male and female circumcision associated with prevalent HIV infection in virgins and adolescents in Kenya, Lesotho, and Tanzania
Male and female circumcision associated with prevalent HIV infection in virgins and adolescents in Kenya, Lesotho, and Tanzania
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DOI：
10.1016/j.annepidem.2006.10.010
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发表时间：
2007-03-01
影响因子：
5.6
通讯作者：
Brody, Stuart
中科院分区：
文献类型：
--
作者：
Brewer, Devon D.;Potterat, John J.;Brody, Stuart
目得：在东部和南部非洲，自我报告的处女和青少年感染艾滋病毒的比例很高，但尚未对这些人的非性传播途径进行系统调查。该地区的许多观察家已经认识到，不卫生的包皮环切手术可能会传播艾滋病毒。我们评估了男性和女性割礼之间的关系，（生殖器切割）和流行的艾滋病毒感染在肯尼亚，莱索托，坦桑尼亚处女和青少年.方法：我们分析了最近的横断面全国概率抽样调查的数据，青少年和成年人在家庭，重点人群中，包皮环切术是常见的，通常发生在青春期或以后.结果：包皮环切的男性和女性处女比未包皮环切的处女更有可能感染艾滋病毒（肯尼亚女性：3.2% vs. 1.4%，比值比[OR] = 2.38;肯尼亚男性：1.8% vs. 0%，OR未定义;莱索托男性：6.1% vs. 1.9%，OR 3.36;坦桑尼亚男性：2.9% vs. 1.0%，OR 2.99;加权平均phi相关性= 0.07，95%置信区间，0.03 - 0.11）。在青少年中，无论性经历如何，包皮环切术与艾滋病毒感染的流行同样密切相关。然而，未割包皮的成年人比割包皮的成年人更有可能是艾滋病毒阳性。自我报告的性经验是独立相关的肯尼亚青少年女性的艾滋病毒感染，但在肯尼亚，Lesothoan和坦桑尼亚的男性青少年的艾滋病毒感染无关。结论：艾滋病毒传播可能会发生通过包皮环切术相关的血液暴露在东部和南部非洲。
PURPOSE: Remarkable proportions of self-reported virgins and adolescents in eastern and southern Africa are infected with HIV, yet non-sexual routes of transmission have not been systematically investigated in such persons. Many observers in this region have recognized the potential for HIV transmission through Unhygienic circumcision procedures. We assessed the relation between male and female circumcision (genital cutting) and prevalent HIV infection in Kenyan, Lesothoan, and Tanzanian virgins and adolescents.METHODS: We analyzed data from recent cross-sectional national probability sample surveys of adolescents and adults in households, focusing on populations in which circumcision was common and usually occurred in puberty or later.RESULTS: Circumcised male and female virgins were substantially more likely to be HIV infected than uncircumcised virgins (Kenyan females: 3.2% vs. 1.4%, odds ratio [OR] = 2.38; Kenyan males: 1.8% vs. 0%, OR undefined; Lesothoan males: 6.1% vs. 1.9%, OR 3.36; Tanzanian males: 2.9% vs. 1.0%, OR 2.99; weighted mean phi correlation = 0.07, 95% confidence interval, 0.03 to 0.11). Among adolescents, regardless of sexual experience, circumcision was just as strongly associated with prevalent HIV infection. However, uncircumcised adults were more likely to be HIV positive than circumcised adults. Self-reported sexual experience was independently related to HIV infection in adolescent Kenyan females, but was unrelated to HIV infection in adolescent Kenyan, Lesothoan, and Tanzanian males.CONCLUSIONS: HIV transmission may occur through circumcision-related blood exposures in eastern and southern Africa.