Male circumcision and risk of HIV-1 and other sexually transmitted infections in India.
Circumcised men have a lower risk of HIV-1 infection than uncircumcised men. Laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. However, some data suggest that circumcision could simply be a marker for low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0.15; 95% CI 0.04-0.62; p=0.0089); however, we noted no protective effect against herpes simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1.
Reynolds
Steven J
SJ
Division of Infectious Diseases, Johns Hopkins University Medical School, Ross 1150, 720 Rutland Avenue, Baltimore, Maryland 21205, USA.
Shepherd
Mary E
ME
Risbud
Arun R
AR
Gangakhedkar
Raman R
RR
Brookmeyer
Ronald S
RS
Divekar
Anand D
AD
Mehendale
Sanjay M
SM
Bollinger
Robert C
RC
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D002944:Circumcision, Male / Q000706:statistics & numerical data; D015331:Cohort Studies; D006069:Gonorrhea / Q000453:epidemiology; D006558:Herpes Genitalis / Q000453:epidemiology / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1; D007194:India / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control; D013587:Syphilis / Q000453:epidemiology