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HIV-1 prevalence and risk of seroconversion among uncircumcised men in Kenya.


Int Conf AIDS. 1992 Jul 19-24;8(2):C296 (abstract no. PoC 4308). Unique

OBJECTIVES: The principle route of HIV transmission in sub-Saharan Africa is heterosexual intercourse. Cofactors, such as genital ulcer disease (GUD) and a lack of male circumcision, may enhance transmission. This study compares HIV-1 prevalence and the risk of seroconversion among uncircumcised and circumcised men with GUD. METHODS: Men presenting to a referral STD clinic in Nairobi with chancroid were counselled, treated, tested for HIV-1, and then followed monthly. This analysis includes 316 circumcised and 97 uncircumcised men who completed a minimum 6 weeks of follow-up. RESULTS: Uncircumcised men had a higher HIV-1 seroprevalence at presentation (51% vs. 16%; OR 5.4, 95% CI 3.2-9.2) and a higher seroconversion rate during follow-up (27% vs. 6%; OR 5.3, 95% CI 2.3-13.1). Over the study period, 64% of uncircumcised and 21% of circumcised men were HIV-1 positive (OR 6.6, 95% CI 3.9-11.1). Comparison of uncircumcised and circumcised men showed no differences in age (27.0 vs. 26.9), past GUD (26% vs. 27%), past urethral discharge (51% vs. 51%), contracting the ulcer from a prostitute (54% vs 58%), or positive chancroid cultures (70% vs. 63%). Other risk factors such as transfusions, tattoos, IVDA, or homosexuality were remarkably low in both groups. CONCLUSIONS: In men with acute GUD, the HIV-1 prevalence and seroconversion rates were much higher in the uncircumcised. Male circumcision may be an important intervention strategy to control the spread of AIDS in some populations.

Adult *Circumcision Human HIV Seropositivity/*EPIDEMIOLOGY *HIV Seroprevalence HIV-1/*IMMUNOLOGY Kenya/EPIDEMIOLOGY Male Risk Factors Sexually Transmitted Diseases/COMPLICATIONS Urogenital Diseases/COMPLICATIONS ABSTRACT


Information in this article was accurate in December 30, 1992. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.