Role of male circumcision in HIV transmission insignificant in conjugal relationship

Abstract

BACKGROUND: Some anthropological studies and review of dozens of epidemiologic studies suggests that the relative risk of heterosexual HIV infection, the predominant route HIV is spread throughout Africa and Asia, is two to eight times higher for uncircumcised men. While this may be true for efficiency of HIV transmission rate per sexual act, the effect of circumcision on HIV transmission in conjugal relationship has been an important area of study. The suggestion that the public health promotion of male circumcision could potentially save millions of men and their partners from becoming infected with HIV has generated some debate.

METHODS: A retrospective study of among index cases attending a comprehensive HIV Care Clinic was conducted. We analysed their marital status, whether they were circumcised and HIV concordance in conjugal relationship to establish the effect of circumcision on protection offered to their spouses or vice versa from HIV infection. This was compared to equal number of non-circumcised men from the same study group.

RESULTS: Of the total 3223 live HIV patients, 210 belonged to Muslim community that follows male-circumcision as a cultural practice, of which 168 were married. Of the 40 discordant patients, men:women ratio was 35:5; while in control group of the 47 discordant patients this ratio was 37:10. The table reveals the findings with respect to HIV status and circumcision. The HIV discordance rate among couples did not differ according to the status ofcircumcision. [table: see text]

CONCLUSION: Though circumcision offers protection in acquisition of HIV infection, our findings reveal that it does not reduce transmission of HIV in conjugal settings. This is important in formulating IEC messages since many believe that circumsized men don't acquire nor likely to transmit HIV infection as a protection derived by circumcision and may continue the risk behaviour.

Keywords: AEGIS, Circumcision, HIV Infections, HIV Seropositivity, Heterosexuality, Marital Status, Family Characteristics, Risk-Taking, Demography, Epidemiologic Studies, Retrospective Studies, Africa, Asia, Human, Male, Female, transmission, surgery, circumcision, hiv infections, hiv seropositivity, heterosexuality, marital status, family characteristics, risk-taking, demography, epidemiologic studies, retrospective studies, africa, asia, human, male, female, transmission, surgery

020707
ThPeC7420