title: Association between HIV and subpreputial penile wetness in uncircumcised men in South Africa.
abstract: 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.
authors.affiliation: Pasteur Suite, Ealing Hospital, and Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK. Nigel.OFarrell@lshtm.ac.uk
authors.forename: Nigel
authors.initials: N
authors.lastname: O'Farrell
authors.forename: Linda
authors.initials: L
authors.lastname: Morison
authors.forename: Prashini
authors.initials: P
authors.lastname: Moodley
authors.forename: Keshree
authors.initials: K
authors.lastname: Pillay
authors.forename: Trusha
authors.initials: T
authors.lastname: Vanmali
authors.forename: Maria
authors.initials: M
authors.lastname: Quigley
authors.forename: Richard
authors.initials: R
authors.lastname: Hayes
authors.forename: A Willem
authors.initials: AW
authors.lastname: Sturm
mesh_terms: 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