Is male circumcision protective of HIV infection?
Background: There is a large body of literature indicating that male circumcision has a protective effect against HIV infection; however, not all studies find this effect. This study examines the association between male circumcision and HIV serostatus across sub-Saharan African countries.
Methods: Data are from recent Demographic and Health Surveys in Burkina Faso, Cameroon, Ghana, Kenya, Lesotho, and Malawi and from AIDS Indicator Surveys in Tanzania and Uganda. During survey fieldwork in each of these countries, men age 15-59 (15-54 in Kenya and 15-49 in Tanzania) gave blood for anonymous HIV testing. HIV serostatus data for men were analyzed for their relationship to reported circumcision status using bivariate and multivariate statistical methods, after controlling for key demographic, social, and behavioral characteristics.
Results: National HIV prevalence ranged from 2% in Ghana and Burkina Faso to 24% in Lesotho. The proportion of uncircumcised men was highest in Lesotho (52%), and lowest in Ghana (5%). In bivariate analysis, circumcised men had lower HIV prevalence in only two of the eight countries. With age, education, wealth status, and a number of sexual and other behavioral risk factors controlled statistically, in only one of the eight countries were circumcised men at a significant advantage. In the other seven countries, the association between circumcision and HIV status was not statistically significant for the male population as a whole.
Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs.
AIDS 2006 - XVI International AIDS Conference
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Is male circumcision protective of HIV infection?.
AIDS 2006 - XVI International AIDS Conference: