Eaton L A, Cain D N, Agrawal A, Jooste S, Udemans N, Kalichman S C
Department of Psychology, University of Connecticut, Storrs, CT 06269, USA.
Int J STD AIDS. 2011 Nov;22(11):674-9. doi: 10.1258/ijsa.2011.011006.
We examined the relationship between HIV prevention beliefs related to male circumcision and sexual behaviour/sexually transmitted infection (STI) acquisition among traditionally circumcised men in Cape Town, South Africa. HIV-negative men (n = 304), circumcised for cultural/religious reasons, attending a health clinic in Cape Town, South Africa, completed cross-sectional surveys. Generalized linear models were used to analyse the relationships between unprotected vaginal sex acts, number of female sexual partners, STI diagnoses and male circumcision-related beliefs and risk perceptions. Men who were aware that circumcision offers protection against HIV (relative risk [RR] = 1.19, 95% confidence interval [CI] = 1.06-1.32, P < 0.01), endorsed risk compensation related to male circumcision (RR = 1.15, 95% CI = 1.11-1.12, P < 0.01) and perceived lower risk of HIV infection when circumcised (RR = 1.08, 95% CI = 1.04-1.12, P < 0.01) were more likely to report unprotected vaginal sex acts. Similar patterns were also identified when predicting number of female sexual partners. Men who were more likely to endorse risk compensation related to male circumcision were also more likely to be diagnosed with a chronic STI (odds ratio [OR] = 1.64, 95% CI = 1.06-2.53, P < 0.05). Our findings suggest that we must not overlook the effects of beliefs towards male circumcision for HIV prevention among men traditionally circumcised; doing so may undermine current efforts to reduce HIV transmission through male circumcision.
我们研究了南非开普敦传统割礼男性中，与男性割礼相关的艾滋病预防信念和性行为/性传播感染（STI）感染之间的关系。因文化/宗教原因接受割礼的HIV阴性男性（n = 304），在南非开普敦的一家健康诊所接受了横断面调查。使用广义线性模型分析无保护阴道性行为、女性性伴侣数量、STI诊断与男性割礼相关信念和风险认知之间的关系。意识到割礼可预防HIV的男性（相对风险[RR]=1.19，95%置信区间[CI]=1.06 - 1.32，P<0.01）、认可与男性割礼相关的风险补偿的男性（RR = 1.15，95% CI = 1.11 - 1.12，P<0.01）以及认为割礼后感染HIV风险较低的男性（RR = 1.08，95% CI = 1.04 - 1.12，P<0.01）更有可能报告无保护阴道性行为。在预测女性性伴侣数量时也发现了类似模式。更有可能认可与男性割礼相关风险补偿的男性也更有可能被诊断为慢性STI（优势比[OR]=1.64，95% CI = 1.06 - 2.53，P<0.05）。我们的研究结果表明，对于传统割礼男性中关于男性割礼预防HIV的信念的影响，我们绝不能忽视；否则可能会破坏目前通过男性割礼减少HIV传播的努力。
