O'Farrell Nigel, Morison Linda, Moodley Prashini, Pillay Keshree, Vanmali Trusha, Quigley Maria, Hayes Richard, Sturm A Willem
Pasteur Suite, Ealing Hospital, and Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
J Acquir Immune Defic Syndr. 2006 Sep;43(1):69-77. doi: 10.1097/01.qai.0000225014.61192.98.
To describe the prevalence and characteristics of subpreputial penile wetness and to investigate the association between current levels of penile wetness and HIV infection.
Male attenders at a sexually transmitted infections clinic in Durban, South Africa were enrolled and treated for their presenting sexually transmitted infection complaint. They were asked to return after 14 days when a structured questionnaire was administered, and the degree of wetness of the glans penis and coronal sulcus was assessed clinically.
Six hundred and fifty men were enrolled, and 488 (75%) returned. Three hundred eighty-six uncircumcised men were included for statistical analysis of whom 215 (56%) were HIV positive. One hundred ninety-six (50.8%) had no penile wetness, and 190 (49.2%) had penile wetness. In the adjusted analysis, penile wetness was associated with younger age, low level of attained education, low income, higher lifetime numbers of sexual partners, and not washing after sex. The prevalence of HIV was greater in those with penile wetness 126 of 190 (66.3%) compared with 90 of 196 (45.9%) with no penile wetness, crude prevalence odds ratio 2.32 (95% confidence interval [CI], 1.54-3.50, P=or<0.001), crude prevalence relative risk 1.44 (95% CI, 1.23-1.63, P=or<0.001), and adjusted for predictors of HIV, confounders and herpes type 2 antibodies, odds ratio 2.38 (95% CI, 1.42-3.97, P=or<0.001), and relative risk 1.46 (95% CI, 1.19-1.68, P=or<0.001).
This is the first study to show an association between subpreputial penile wetness and HIV. Consideration should be given to providing advice about improving penile hygiene in uncircumcised men in areas where HIV is a significant problem. Good penile hygiene should also be promoted at the community level to become a desirable social norm.
描述阴茎包皮下潮湿的患病率及特征，并调查当前阴茎潮湿水平与艾滋病毒感染之间的关联。
纳入南非德班一家性传播感染诊所的男性就诊者，对其当前的性传播感染主诉进行治疗。要求他们在14天后返回，届时进行结构化问卷调查，并临床评估阴茎头和冠状沟的潮湿程度。
共纳入650名男性，488人（75%）返回。386名未行包皮环切术的男性纳入统计分析，其中215人（56%）为艾滋病毒阳性。196人（50.8%）阴茎无潮湿，190人（49.2%）阴茎有潮湿。在调整分析中，阴茎潮湿与年龄较小、受教育程度低、收入低、性伴侣终身数量较多以及性交后不清洗有关。阴茎有潮湿者的艾滋病毒患病率更高，190人中有126人（66.3%），而阴茎无潮湿者196人中有90人（45.9%），粗患病率比值比为2.32（95%置信区间[CI]，1.54 - 3.50，P≤0.001），粗患病率相对风险为1.44（95%CI，1.23 - 1.63，P≤0.001），在对艾滋病毒的预测因素、混杂因素和2型疱疹抗体进行调整后，比值比为2.38（95%CI，1.42 - 3.97，P≤0.001），相对风险为1.46（95%CI，1.19 - 1.68，P≤0.001）。
这是第一项显示阴茎包皮下潮湿与艾滋病毒之间存在关联的研究。在艾滋病毒问题严重的地区，应考虑为未行包皮环切术的男性提供改善阴茎卫生的建议。还应在社区层面推广良好的阴茎卫生习惯，使其成为一种理想的社会规范。
