Mutombo Namuunda, Maina Beatrice, Jamali Monica
African Population and Health Research Center (APHRC), P.O Box 10787, 00100, Nairobi, Kenya.
APHRC, Nairobi, Kenya.
BMC Public Health. 2015 Oct 13;15:1051. doi: 10.1186/s12889-015-2384-z.
The HIV epidemic remains a major health challenge all over the world. In 2013, an estimated 35million people were living with HIV globally. Male circumcision is increasingly being adopted as a method of HIV prevention. WHO and UNAIDS have advised that male circumcision be added to current HIV interventions. Malawi is one of the countries hardest hit by HIV/AIDS with a prevalence rate of 11 % and male circumcision prevalence of 21.6 % in 2010. Prior to 2011, traditional male circumcision in Malawi was the dominant form of male circumcision, mainly for cultural and religious reasons. This paper looks at male circumcision as a prevention method against HIV by examining the relationship between male circumcision and HIV status among Malawian men.
The data used were collected as part of the 2010 Malawi Demographic and Health Survey. The methodology used in the 2010 MDHS has been comprehensively described by the National Statistical Office of Malawi and ICF Macro. Our analysis is based on men aged 15-54 years who were tested for HIV and responded to questions on circumcision during the survey. Sixty one percent of the 7175 men interviewed in the MDHS, qualified for this analysis. The sample was weighted to ensure representativeness. Frequencies, cross-tabulations, univariate and multivariate logistic regressions were conducted. Differences in the prevalence of HIV infection among circumcised and uncircumcised men were determined with Chi-squared tests.
There is no significant difference in HIV prevalence between circumcised (12 %) and uncircumcised men (10 %). Among circumcised men, age and number of lifetime partners are the dominant correlates of HIV status. Additionally, circumcised men who have had ritual sex are two times more likely (OR = 2.399) to be HIV+ compared to circumcised men who have never had ritual sex.
This study has demonstrated that traditional male circumcision was not associated with HIV infection in pre-2010 Malawi. Among circumcised men, age and number of lifetime partners are correlates to HIV status while circumcised men who have had ritual sex are more likely to be diagnosed with HIV than circumcised men who have not had ritual sex.
艾滋病疫情仍是全球主要的健康挑战。2013年，全球估计有3500万人感染艾滋病毒。男性包皮环切术越来越多地被用作预防艾滋病毒的一种方法。世界卫生组织和联合国艾滋病规划署建议将男性包皮环切术纳入当前的艾滋病毒干预措施中。马拉维是受艾滋病毒/艾滋病影响最严重的国家之一，2010年的患病率为11%，男性包皮环切术的普及率为21.6%。2011年之前，由于文化和宗教原因，传统的男性包皮环切术在马拉维是男性包皮环切术的主要形式。本文通过研究马拉维男性包皮环切术与艾滋病毒感染状况之间的关系，探讨男性包皮环切术作为预防艾滋病毒的一种方法。
所使用的数据是作为2010年马拉维人口与健康调查的一部分收集的。2010年马拉维人口与健康调查所采用的方法已由马拉维国家统计局和国际家庭保健组织进行了全面描述。我们的分析基于年龄在15至54岁之间、接受过艾滋病毒检测并在调查期间回答了有关包皮环切术问题的男性。在马拉维人口与健康调查中接受访谈的7175名男性中，61%符合此项分析要求。对样本进行加权以确保代表性。进行了频率分析、交叉制表分析、单变量和多变量逻辑回归分析。通过卡方检验确定包皮环切和未包皮环切男性中艾滋病毒感染率的差异。
包皮环切男性（12%）和未包皮环切男性（10%）的艾滋病毒感染率没有显著差异。在包皮环切男性中，年龄和终身性伴侣数量是艾滋病毒感染状况的主要相关因素。此外，与从未有过仪式性性行为的包皮环切男性相比，有过仪式性性行为的包皮环切男性感染艾滋病毒的可能性高出两倍（比值比=2.399）。
本研究表明，在2010年前的马拉维，传统的男性包皮环切术与艾滋病毒感染无关。在包皮环切男性中，年龄和终身性伴侣数量与艾滋病毒感染状况相关，有过仪式性性行为的包皮环切男性比没有过仪式性性行为的包皮环切男性更有可能被诊断出感染艾滋病毒。
