Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Cairns, 4870, QLD, Australia.
College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, 4870, QLD, Australia.
PLoS One. 2015 Apr 13;10(4):e0123429. doi: 10.1371/journal.pone.0123429. eCollection 2015.
Male circumcision (MC) is a well-established component of HIV prevention in countries with high HIV prevalence and heterosexually driven epidemics. Delivery and monitoring of MC programs are reliant on good quality MC data. Such data are often generated through self-reported MC status surveys. This study examined self-reported MC status in comparison with genital photographs from men in Papua New Guinea (PNG).
This retrospective non-interventional study collated self-reported MC status data from the 'acceptability and feasibility of MC' study at 4 sites in PNG during 2010-2011. Participants reported their MC status based on an 8-category photographic classification covering the range of foreskin cutting practices in PNG. Genital photographs of 222 participants from this study were independently classified by 2 investigators. The 8-category photographic classification was simplified into a 3 category classification of 'no cut', 'straight cut' and 'round cut' before comparing for agreement between self-reporting and investigator assessment using Cohen's Kappa measure.
Using the 3-category classification, there was 90.6% (201/222) agreement between self-assessment and investigator classification (κ value 0.805). Of the discordant 9.4% (21/222), 3.6% (8/222) self-classified as having a cut foreskin (5 straight cut; 3 round cut) while investigators classified as having no cut; 4.1% (9/222) self-classified as having no cut while investigators classified them as having had a cut (6 straight cut; 3 round cut) and 1.8% (4/222) self-classified as having a round cut while investigators classified as having a straight cut. Given the great variety of foreskin cutting practices and appearances, feasible explanations are suggested for two-thirds (13/21) of these discordant results.
This study demonstrates a high level of agreement between self-reporting and investigator assessment of MC status in PNG and suggests self-reporting of MC status to be highly reliable among men in PNG.
在艾滋病高发和异性传播为主的国家，男性割礼（MC）是艾滋病预防的一个成熟组成部分。MC 项目的提供和监测依赖于高质量的 MC 数据。此类数据通常通过自我报告的 MC 状态调查产生。本研究比较了巴布亚新几内亚（PNG）男性的自我报告 MC 状态和生殖器照片。
这项回顾性非干预性研究收集了 2010-2011 年在 PNG 4 个地点进行的“MC 可接受性和可行性”研究中的自我报告 MC 状态数据。参与者根据涵盖 PNG 包皮切割范围的 8 类照片分类，报告他们的 MC 状态。从这项研究中收集了 222 名参与者的生殖器照片，由 2 名调查员独立进行分类。在使用 Cohen's Kappa 测量值比较自我报告和调查员评估之间的一致性之前，将 8 类照片分类简化为“未切割”、“直切”和“环切”的 3 类分类。
使用 3 类分类，自我评估和调查员分类之间有 90.6%（201/222）的一致性（κ 值 0.805）。在 9.4%（21/222）不一致的情况下，3.6%（8/222）自我分类为有切割包皮（5 个直切；3 个环切），而调查员分类为未切割；4.1%（9/222）自我分类为未切割，而调查员分类为切割（6 个直切；3 个环切），1.8%（4/222）自我分类为环切，而调查员分类为直切。鉴于包皮切割做法和外观的多样性，对于三分之二（13/21）的这些不一致结果，提出了可行的解释。
本研究表明，在 PNG，自我报告的 MC 状态与调查员评估之间具有高度一致性，并表明在 PNG 男性中，自我报告的 MC 状态非常可靠。
