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HIV-1 prevalence and risk of seroconversion among uncircumcised men in Kenya.
Tyndall M; Agoki E; Malisa W; Ronald AR; Ndinya-Achola JO; Plummer FA;
December 30, 1992
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