AEGiS-14IAC: HIV-1 prevalence in circumcised versus uncircumcised Luo men from African instituted churches in rural Kenya.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

HIV-1 prevalence in circumcised versus uncircumcised Luo men from African instituted churches in rural Kenya.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1486)

Agot K, Ndinya-Achola JO, Kreiss JK, Weiss NS
UNIM Project, Kisumu, Kenya

BACKGROUND: There is increasing evidence linking lack of male circumcision with elevated risk of HIV-1. Male circumcision has thus been suggested as a possible strategy to control the rapid spread of HIV/AIDS in Africa. Others, however, have felt that available evidence is not sufficient to justify such a recommendation because the associations reported may have been influenced by possible confounding. Of particular concern is that cultural differences between circumcised and non-circumcised men may be associated with their sexual practices and may, in turn, affect their exposure to HIV-1. To address this concern, we compared the seroprevalence of HIV-1 between uncircumcised and circumcised men from the same ethnic community.

METHODS: We conducted a cross-sectional study among the Luo ethnic community in rural Kenya. Of 1217 eligible men (18-59 years of age, sexually active, and a member of an African instituted church congregation), 845 agreed to give blood samples for HIV-1 testing and to have their circumcision status verified.

RESULTS: The seroprevalence of HIV-1 was 30.2% among 447 uncircumcised men and 19.8% among 398 circumcised men. Among uncircumcised men, HIV-1 seroprevalence was similar whether they were members of churches that did not advocate circumcision (30.1%, n=336) or those in which circumcision was recommended (30.6%, n=111). Except for those reporting consistent condom use, uncircumcised men had a higher prevalence of HIV-1 seropositivity compared to circumcised men in all strata of selected demographic and sexual behavioral factors. The crude prevalence ratio was 1.51 (95% CI = 1.17-1.96), and adjustment for other measured risk factors for HIV-1 infection had little or no impact on this result.

CONCLUSION: Our study provides evidence that circumcision is associated with a reduced risk of HIV-1 infection in this relatively homogeneous population.

Keywords: AEGIS, Prevalence, HIV-1, HIV Infections, Circumcision, Cross-Sectional Studies, Risk Factors, HIV Seroprevalence, Ethnic Groups, Kenya, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Demography, Seroepidemiologic Studies, Africa, Human, Male, epidemiology, surgery

020707
ThOrC1486