在阿根廷布宜诺斯艾利斯，男男性行为者中接受过割礼的比例较低，且不愿意接受割礼：与性传播感染有关。
Low frequency of male circumcision and unwillingness to be circumcised among MSM in Buenos Aires, Argentina: association with sexually transmitted infections.
机构信息
Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
出版信息
J Int AIDS Soc. 2013 Jun 6;16(1):18500. doi: 10.7448/IAS.16.1.18500.
OBJECTIVE
The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM) in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs); and, among those uncircumcised, the willingness to be circumcised.
METHODS
A cross-sectional study was conducted among 500 MSM recruited through the respondent-driven sampling (RDS) technique. Participants underwent a consent process, responded to a Web-based survey that included questions on demographic information, sexual behaviour, and circumcision and provided biological samples. HIV, hepatitis B virus (HBV), hepatitis C virus (CV), Treponema pallidum, and human papiloma virus (HPV) diagnoses were performed using standard methodologies. For all analyses, data were weighted based on participants' network size.
RESULTS
Only 64 (13%) of the 500 MSM in our study reported being circumcised. Among uncircumcised men (n=418), 302 (70.4%) said that they would not be willing to get circumcised even if the procedure could reduce the risk of HIV infection. When considering all participants, circumcision status was not significantly associated with HIV, HBV, HCV, T. pallidum or HPV infections. However, when we restricted the sample to men who do not practice receptive anal intercourse (RAI) and compared circumcised to uncircumcised men, the former (N=33) had no cases of HIV infection, while 34 of 231 (14.8%) uncircumcised men were HIV positive (p=0.020). Regarding HPV, uncircumcised men had a significantly larger number of different HPV types compared with circumcised men (mean 1.83 vs. 1.09, p<0.001) and a higher frequency of high-risk-HPV genotypes (47.6% vs. 12.5%, p=0.012).
CONCLUSIONS
Consistent with international evidence, male circumcision appears to have a partial protective effect among MSM. The efficacy of circumcision in reducing risk of HIV infection among MSM appears to be correlated with sexual practices. Given the lack of motivation among MSM with regard to circumcision, proper awareness on the risks and benefits of circumcision needs to be created, if circumcision has to be introduced as a prevention strategy.
目的
本研究旨在调查阿根廷布宜诺斯艾利斯男男性行为者（MSM）中男性割礼的频率；割礼与性传播感染（STI）之间的关联；以及在未割礼的人群中，愿意割礼的意愿。
方法
采用应答驱动抽样（RDS）技术对 500 名 MSM 进行横断面研究。参与者经过同意过程，回答了一项基于网络的调查，其中包括人口统计学信息、性行为和割礼问题，并提供了生物样本。使用标准方法进行 HIV、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）、梅毒螺旋体和人乳头瘤病毒（HPV）诊断。对于所有分析，根据参与者的网络规模对数据进行加权。
结果
在我们的研究中，只有 64 名（13%）500 名 MSM 报告说他们接受了割礼。在未割礼的男性中（n=418），302 名（70.4%）表示即使割礼可以降低 HIV 感染的风险，他们也不愿意接受割礼。当考虑所有参与者时，割礼状况与 HIV、HBV、HCV、T. pallidum 或 HPV 感染无显著关联。然而，当我们将样本限制在不进行接受性肛交（RAI）的男性，并将割礼与未割礼的男性进行比较时，前者（N=33）没有 HIV 感染病例，而 231 名未割礼男性中有 34 名（14.8%）HIV 阳性（p=0.020）。关于 HPV，未割礼的男性与割礼的男性相比，具有显著更多不同的 HPV 类型（平均 1.83 比 1.09，p<0.001）和更高的高危 HPV 基因型频率（47.6% 比 12.5%，p=0.012）。
结论
与国际证据一致，男性割礼似乎对 MSM 具有部分保护作用。割礼在降低 MSM 中 HIV 感染风险方面的效果似乎与性行为有关。鉴于 MSM 对割礼缺乏动力，如果要引入割礼作为预防策略，需要正确认识割礼的风险和益处。
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