Association between HIV and subpreputial penile wetness in uncircumcised men in South Africa.
OBJECTIVE
To describe the prevalence and characteristics of subpreputial penile wetness and to investigate the association between current levels of penile wetness and HIV infection.


METHODS
Male attenders at a sexually transmitted infections clinic in Durban, South Africa were enrolled and treated for their presenting sexually transmitted infection complaint. They were asked to return after 14 days when a structured questionnaire was administered, and the degree of wetness of the glans penis and coronal sulcus was assessed clinically.


RESULTS
Six hundred and fifty men were enrolled, and 488 (75%) returned. Three hundred eighty-six uncircumcised men were included for statistical analysis of whom 215 (56%) were HIV positive. One hundred ninety-six (50.8%) had no penile wetness, and 190 (49.2%) had penile wetness. In the adjusted analysis, penile wetness was associated with younger age, low level of attained education, low income, higher lifetime numbers of sexual partners, and not washing after sex. The prevalence of HIV was greater in those with penile wetness 126 of 190 (66.3%) compared with 90 of 196 (45.9%) with no penile wetness, crude prevalence odds ratio 2.32 (95% confidence interval [CI], 1.54-3.50, P=or<0.001), crude prevalence relative risk 1.44 (95% CI, 1.23-1.63, P=or<0.001), and adjusted for predictors of HIV, confounders and herpes type 2 antibodies, odds ratio 2.38 (95% CI, 1.42-3.97, P=or<0.001), and relative risk 1.46 (95% CI, 1.19-1.68, P=or<0.001).


CONCLUSIONS
This is the first study to show an association between subpreputial penile wetness and HIV. Consideration should be given to providing advice about improving penile hygiene in uncircumcised men in areas where HIV is a significant problem. Good penile hygiene should also be promoted at the community level to become a desirable social norm.
O'Farrell
Nigel
N
Pasteur Suite, Ealing Hospital, and Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK. Nigel.OFarrell@lshtm.ac.uk
Morison
Linda
L
Moodley
Prashini
P
Pillay
Keshree
K
Vanmali
Trusha
T
Quigley
Maria
M
Hayes
Richard
R
Sturm
A Willem
AW
D000328:Adult; D044383:Black People; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010409:Penile Diseases / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires