苏格兰男男性行为者中的割礼:预防 HIV 的潜力有限。
Circumcision among men who have sex with men in Scotland: limited potential for HIV prevention.
机构信息
MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK.
出版信息
Sex Transm Infect. 2010 Oct;86(5):404-6. doi: 10.1136/sti.2010.042895. Epub 2010 Jun 30.
OBJECTIVE
Male circumcision has been shown to reduce the risk of HIV acquisition among heterosexual men but the impact among men who have sex with men (MSM) is not known. In this paper, we explore the feasibility of research into circumcision for HIV prevention among MSM in Scotland.
METHODS
Anonymous, self-complete questionnaires and Orasure oral fluid collection kits were distributed to men visiting the commercial gay scenes in Glasgow and Edinburgh.
RESULTS
1508 men completed questionnaires (70.5% response rate) and 1277 provided oral fluid samples (59.7% response rate). Overall, 1405 men were eligible for inclusion in the analyses. 16.6% reported having been circumcised. HIV prevalence was similar among circumcised and uncircumcised men (4.2% and 4.6%, respectively). Although biologically, circumcision is most likely to protect against HIV for men practising unprotected insertive anal intercourse (UIAI), only 7.8% (91/1172) of uncircumcised men reported exclusive UIAI in the past 12 months. Relatively few men reported being willing to participate in a research study on circumcision and HIV prevention (13.9%), and only 11.3% of uncircumcised men did so.
CONCLUSION
The lack of association between circumcision and HIV status, low levels of exclusive UIAI, and low levels of willingness to take part in circumcision research studies suggest circumcision is unlikely to be a feasible HIV prevention strategy for MSM in the UK. Behaviour change should continue to be the focus of HIV prevention in this population.
目的
男性割礼已被证明可降低异性恋男性感染艾滋病毒的风险,但尚不清楚其对男男性行为者(MSM)的影响。本文探讨了在苏格兰对 MSM 进行割礼预防艾滋病毒研究的可行性。
方法
向访问格拉斯哥和爱丁堡商业同性恋场所的男性分发匿名、自我完成的问卷和 OraSure 口腔液采集套件。
结果
1508 名男性完成了问卷(70.5%的回复率),1277 名提供了口腔液样本(59.7%的回复率)。总体而言,有 1405 名男性符合纳入分析的条件。16.6%的人报告曾接受过割礼。割礼与未割礼男性的艾滋病毒感染率相似(分别为 4.2%和 4.6%)。尽管从生物学角度来看,割礼最有可能保护未采取保护措施的插入式肛交(UIAI)的男性免受 HIV 感染,但在过去 12 个月中,只有 7.8%(91/1172)的未割礼男性报告曾进行过纯粹的 UIAI。相对较少的男性表示愿意参与关于割礼和 HIV 预防的研究(13.9%),只有 11.3%的未割礼男性表示愿意。
结论
割礼与 HIV 状态之间缺乏关联、纯粹的 UIAI 水平较低,以及参与割礼研究的意愿较低,表明割礼不太可能成为英国 MSM 的可行 HIV 预防策略。在该人群中,行为改变应继续成为 HIV 预防的重点。