Male circumcision and susceptibility to HIV infection among men in Tanzania
Male circumcision and susceptibility to HIV infection among men in Tanzania
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DOI：
10.1097/00002030-199701000-00011
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发表时间：
1997-01-01
期刊：
影响因子：
3.8
通讯作者：
Isingo, R
中科院分区：
文献类型：
--
作者：
Urassa, M;Todd, J;Isingo, R
背景资料：来自生态研究和对撒哈拉以南非洲性病患者的研究的证据表明，男性包皮环切术对艾滋病毒感染具有保护作用。有，但是，很少有基于人口的研究，已充分控制潜在的混杂factors.Methods：数据从五个基于人口的研究在坦桑尼亚西北部被用来调查男性包皮环切术和艾滋病毒感染和性病的风险之间的关联。包皮环切术对艾滋病毒感染率，梅毒（阳性梅毒螺旋体血凝反应; TPHA）和自我报告的性病的影响进行了分析，控制一系列的人口和社会文化变量，和指标的性behaviors.Results：在坦桑尼亚西北部，包皮环切术以前仅限于穆斯林和特定的种族群体，但现在更普遍，特别是在城市地区和受过良好教育的男子。对自我报告的包皮环切状况的可靠性和有效性的评估表明，这些数据可以被认为是相当准确的，尽管包皮环切有一些被过度报告的趋势。在单变量分析中，大多数研究中包皮环切状况与艾滋病毒感染率无关。然而，在控制了混杂变量后，包皮环切术男性的HIV感染率有适度但显著的降低[比值比（OR），0.62; 95%置信区间（CI），0.48-0.81]。这种影响在城市地区（OR，0.46; 95%CI，0.32-0.68）和路边村庄（OR，0.65; 95%CI，0.42-1.01）比农村地区和岛屿（OR，1.00和1.01）更强。包皮环切状态和梅毒血清学（TPHA）之间没有关联，但包皮环切和自我报告的STD之间存在正相关，虽然这是不显着调整后的混杂variables.Conclusion：男性包皮环切对艾滋病毒感染的保护作用，在这一人群中，这可能是更强的城市地区和路边定居点比在农村地区。族裔群体和宗教派别不再是男性割礼的唯一决定因素。
Background: Evidence from ecological studies and from studies of and sexually transmitted disease (STD) patients in sub-Saharan Africa suggests that there is a protective effect of male circumcision against HIV infection. There are, however, few population-based studies that have controlled adequately for potential confounding factors.Methods: Data from five population-based studies in north-western Tanzania were used to investigate the association between male circumcision and the risk of HIV infection and STD. The effects of circumcision on HIV prevalence, syphilis (positive Treponema pallidum haemagglutination; TPHA) and self-reported STD were analysed, controlling for a range of demographic and sociocultural variables, and indicators of sexual behaviour.Results: In north-western Tanzania, circumcision was previously restricted to Muslims and specific ethnic groups, but is now more widespread, particularly in urban areas and among more educated men. Assessment of the reliability and validity of self-reported circumcision status showed that these data could be considered fairly accurate, although there was some tendency for circumcision to be over-reported. On univariate analysis, circumcision status was unrelated to HIV prevalence in most studies. After controlling for confounding variables, however, there was a modest but significant reduction of the HIV prevalence among circumcised men [odds ratio (OR), 0.62; 95% confidence interval (CI), 0.48-0.81]. This effect appeared stronger in urban areas (OR, 0.46; 95% CI, 0.32-0.68) and roadside villages (OR, 0.65; 95% CI, 0.42-1.01) than in rural areas and islands (OR, 1.00 and 1.01 respectively). There was no association between circumcision status and syphilis serology (TPHA), but there was a positive association between circumcision and self-reported STD, although this was not significant after adjustment for confounding variables.Conclusion: Male circumcision has a protective effect against HIV infection in this population, which may be stronger in urban areas and roadside settlements than in the rural areas. Ethnic group and religious denomination are no longer the sole determinants of male circumcision.