Adult male circumcision as an intervention against HIV: An operational study of uptake in a South African community (ANRS 12126)
Adult male circumcision as an intervention against HIV: An operational study of uptake in a South African community (ANRS 12126)
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DOI：
10.1186/1471-2334-11-253
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发表时间：
2011-09-26
影响因子：
3.7
通讯作者：
Auvert, Bertran
中科院分区：
文献类型：
--
作者：
Lissouba, Pascale;Taljaard, Dirk;Auvert, Bertran
背景资料：为了评估知识，态度和信念有关成年男性包皮环切术（AMC），评估AMC与艾滋病的发病率和患病率的关联，并估计AMC的吸收在南部African community.Methods：一个横断面生物医学调查（ANRS-12126）在2007-2008年之间进行随机抽样的1198名男子年龄在15至49岁的橙子农场（南非）。采用结构式问卷进行面对面访谈。使用BED发病率测定评价近期HIV感染。包皮环切状态是自我报告和临床评估。采用Poisson回归分析计算调整后的HIV发病率比（aIRR）和流行率比（aPR）。大多数受访者认为，包皮环切术的男子可能成为艾滋病毒感染者，需要使用安全套，虽然19.3%（95%CI：17.1%至21.6%）声称，AMC完全保护免受艾滋病毒。在自我报告的包皮环切男性中，44.9%（95%CI：39.6%至50.3%）的包皮完整。无包皮男性的HIV发病率和患病率低于有包皮男性（aIRR = 0.35; 95%CI：0.14 - 0.88; aPR = 0.45，95%CI：0.26 - 0.79）。自我报告的包皮环切术男性和其他未包皮环切术男性之间没有显着差异。接受AMC的意愿与种族、伴侣和家庭对AMC的支持有关。结论：该社区AMC感染率较高，但应加强对AMC的宣传和咨询，以明确AMC的临床意义及其对HIV感染的影响。这些研究结果表明，AMC的推出是有希望的，但需要谨慎的实施战略，以成功地对抗非洲艾滋病毒的流行。
Background: To evaluate the knowledge, attitudes and beliefs about adult male circumcision (AMC), assess the association of AMC with HIV incidence and prevalence, and estimate AMC uptake in a Southern African community.Methods: A cross-sectional biomedical survey (ANRS-12126) conducted in 2007-2008 among a random sample of 1198 men aged 15 to 49 from Orange Farm (South Africa). Face-to-face interviews were conducted by structured questionnaire. Recent HIV infections were evaluated using the BED incidence assay. Circumcision status was self-reported and clinically assessed. Adjusted HIV incidence rate ratios (aIRR) and prevalence ratios (aPR) were calculated using Poisson regression.Results: The response rate was 73.9%. Most respondents agreed that circumcised men could become HIV infected and needed to use condoms, although 19.3% (95%CI: 17.1% to 21.6%) asserted that AMC protected fully against HIV. Among self-reported circumcised men, 44.9% (95%CI: 39.6% to 50.3%) had intact foreskins. Men without foreskins had lower HIV incidence and prevalence than men with foreskins (aIRR = 0.35; 95%CI: 0.14 to 0.88; aPR = 0.45, 95%CI: 0.26 to 0.79). No significant difference was found between self-reported circumcised men with foreskins and other uncircumcised men. Intention to undergo AMC was associated with ethnic group and partner and family support of AMC. Uptake of AMC was 58.8% (95%CI: 55.4% to 62.0%).Conclusions: AMC uptake in this community is high but communication and counseling should emphasize what clinical AMC is and its effect on HIV acquisition. These findings suggest that AMC roll-out is promising but requires careful implementation strategies to be successful against the African HIV epidemic.