Eyer-Silva Walter A
Hospital Universitário Gaffrée e Guinle, Universidade do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2003 Oct;37(5):678-86. doi: 10.1590/s0034-89102003000500022. Epub 2003 Oct 9.
Since the early years of the AIDS epidemic significant geographic differences in HIV prevalence were reported within neighboring countries and neighboring regions within the same country in sub-Saharan Africa. These differences could not be fully explained by factors such as sexual behavior and condom use. Mounting epidemiological data have demonstrated that male circumcision is a major protective factor against male heterosexual HIV infection in sub-Saharan Africa and probably contributes to these significant differences in HIV prevalence. This is a review of African studies on the association between male circumcision and HIV infection, the origin of circumcision practices in human societies, potential prepuce mechanisms for increasing male vulnerability to heterosexual HIV infection, its association with other infectious and neoplastic diseases, controversies on the convenience of male circumcision as an HIV control strategy in Africa, the scarce Brazilian literature on male circumcision and perspectives of future research.
自艾滋病流行初期以来，撒哈拉以南非洲地区的邻国以及同一国家内的相邻地区之间报告了显著的艾滋病毒流行率地理差异。这些差异无法完全通过性行为和避孕套使用等因素来解释。越来越多的流行病学数据表明，男性包皮环切术是撒哈拉以南非洲地区男性异性传播艾滋病毒感染的主要保护因素，可能也是造成艾滋病毒流行率显著差异的原因。本文综述了非洲关于男性包皮环切术与艾滋病毒感染之间关联的研究、人类社会中包皮环切术习俗的起源、包皮增加男性异性传播艾滋病毒感染易感性的潜在机制、其与其他传染病和肿瘤性疾病的关联、关于在非洲将男性包皮环切术作为艾滋病毒控制策略是否便利的争议、巴西关于男性包皮环切术的稀少文献以及未来研究的展望。
