Male circumcision and its association with HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in sub-Saharan Africa.

Abstract

The study aimed to assess the association between male circumcision and HIV infection and STDs. The issue is controversial as various studies reported conflicting findings. A cross-sectional comparative study based on the secondary data of 18 Demographic Health Surveys (DHS), carried out in Sub-Saharan Africa starting from 2003, was conducted. From all surveys, information on 70 554 males aged 15 - 59 years was extracted. The association between male circumcision and HIV infection and STD symptoms (genital discharge or genital ulcer/sore) was assessed using binary logistic regression. Adjustment was made for sexual history and basic socio-demographic variables. The weighted prevalence of HIV among men 15 - 59 years was 3.1%. In the bivariate analysis uncircumcised status was significantly associated with risk of HIV, with odds ratio (OR) of 4.12 (95% CI: 3.85 - 4.42). The association was even more significant (4.95 (95% CI: 4.57-5.36)) after adjustment for number of lifetime sexual partners and socio-demographic variables. The risk associated with uncircumcised status is significantly lower among younger men aged 15 - 29 years than those in 30 - 59-year age category. About 5.5% of the study subjects reported either genital discharge or genital sore/ulcer in the preceding 12 months of the surveys. Circumcision status was not significantly associated with either of the symptoms, with adjusted OR of 1.07 (95% CI: 0.99 - 1.15). The study concludes that there is a strong association between uncircumcised status and HIV infection. Hence, male circumcision can be considered as a possible way of reducing the spread of HIV infection in areas where the practice is rare. A comprehensive study to assess the association between circumcision and different types of STDs is recommended.

• Authors: Samson Gebremedhin
• Journal: SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance (SAHARA J) Vol. 8 Issue 1 Pg. 13-8 ( 2011) ISSN: 1813-4424 [Electronic] South Africa
• PMID: 23237641 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Africa South of the Sahara (epidemiology)
• Circumcision, Male (statistics & numerical data)
• Cross-Sectional Studies
• Demography
• Disease Outbreaks (prevention & control)
• HIV Infections (epidemiology, prevention & control, transmission)
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Assessment (statistics & numerical data)
• Young Adult