Medical Sciences Campus-School of Public Health, University of Puerto Rico, San Juan, Puerto Rico.
J Sex Med. 2012 Nov;9(11):2933-7. doi: 10.1111/j.1743-6109.2012.02871.x. Epub 2012 Aug 15.
Circumcision among adult men has been widely promoted as a strategy to reduce human immunodeficiency virus (HIV) transmission risk. However, much of the available data derive from studies conducted in Africa, and there is as yet little research in the Caribbean region where sexual transmission is also a primary contributor to rapidly escalating HIV incidence.
In an effort to fill the void of data from the Caribbean, the objective of this article is to compare history of sexually transmitted infections (STI) and HIV diagnosis in relation to circumcision status in a clinic-based sample of men in Puerto Rico.
Data derive from an ongoing epidemiological study being conducted in a large STI/HIV prevention and treatment center in San Juan in which 660 men were randomly selected from the clinic's waiting room.
We assessed the association between circumcision status and self-reported history of STI/HIV infection using logistic regressions to explore whether circumcision conferred protective benefit.
Almost a third (32.4%) of the men were circumcised (CM). Compared with uncircumcised (UC) men, CM have accumulated larger numbers of STI in their lifetime (CM = 73.4% vs. UC = 65.7%; P = 0.048), have higher rates of previous diagnosis of warts (CM = 18.8% vs. UC = 12.2%; P = 0.024), and were more likely to have HIV infection (CM = 43.0% vs. UC = 33.9%; P = 0.023). Results indicate that being CM predicted the likelihood of HIV infection (P value = 0.027).
These analyses represent the first assessment of the association between circumcision and STI/HIV among men in the Caribbean. While preliminary, the data indicate that in and of itself, circumcision did not confer significant protective benefit against STI/HIV infection. Findings suggest the need to apply caution in the use of circumcision as an HIV prevention strategy, particularly in settings where more effective combinations of interventions have yet to be fully implemented.
在成年男性中进行割礼已被广泛推广为降低人类免疫缺陷病毒（HIV）传播风险的策略。然而，现有的大部分数据都来自非洲的研究，而在加勒比地区，性传播也是导致 HIV 发病率迅速上升的主要原因，该地区的研究却很少。
为了填补加勒比地区数据的空白，本文旨在比较波多黎各一家诊所基于人群的男性中与割礼状况相关的性传播感染（STI）和 HIV 诊断史。
数据来自于在圣胡安的一家大型 STI/HIV 预防和治疗中心进行的一项正在进行的流行病学研究，该研究从诊所候诊室中随机选择了 660 名男性。
我们使用逻辑回归评估了割礼状况与自我报告的 STI/HIV 感染史之间的关联，以探讨割礼是否具有保护作用。
将近三分之一（32.4%）的男性接受了割礼（CM）。与未割礼（UC）男性相比，CM 一生中积累了更多的性传播感染（CM = 73.4% vs. UC = 65.7%；P = 0.048），有更高的生殖器疣既往诊断率（CM = 18.8% vs. UC = 12.2%；P = 0.024），并且更有可能感染 HIV（CM = 43.0% vs. UC = 33.9%；P = 0.023）。结果表明，CM 是 HIV 感染的预测因素（P 值=0.027）。
这些分析代表了加勒比地区男性中割礼与 STI/HIV 之间关联的首次评估。虽然初步结果表明，割礼本身并不能显著降低 STI/HIV 感染的风险。研究结果表明，在尚未全面实施更有效的干预措施组合的情况下，在 HIV 预防策略中使用割礼时需要谨慎。
