OBJECTIVE: To assess circumcision status as a risk factor for HIV seroconversion in homosexual men. DESIGN, SETTING AND PARTICIPANTS: The Health in Men (HIM) study was a prospective cohort of homosexual men in Sydney, Australia. HIV-negative men (n = 1426) were recruited primarily from community-based sources between 2001 and 2004 and followed to mid-2007. Participants underwent annual HIV testing, and detailed information on sexual risk behaviour was collected every 6 months. MAIN OUTCOME MEASURE: HIV incidence in circumcised compared with uncircumcised participants, stratified by whether or not men predominantly practised the insertive role in anal intercourse. RESULTS: There were 53 HIV seroconversions during follow-up; an incidence of 0.78 per 100 person-years. On multivariate analysis controlling for behavioural risk factors, being circumcised was associated with a nonsignificant reduction in risk of HIV seroconversion [hazard ratio 0.78, 95% confidence interval (CI) 0.42-1.45, P = 0.424]. Among one-third of study participants who reported a preference for the insertive role in anal intercourse, being circumcised was associated with a significant reduction in HIV incidence after controlling for age and unprotected anal intercourse (UAI) (hazard ratio 0.11, 95% CI 0.03-0.80, P = 0.041). Those who reported a preference for the insertive role overwhelmingly practised insertive rather than receptive UAI. CONCLUSIONS: Overall, circumcision did not significantly reduce the risk of HIV infection in the HIM cohort. However, it was associated with a significant reduction in HIV incidence among those participants who reported a preference for the insertive role in anal intercourse. Circumcision may have a role as an HIV prevention intervention in this subset of homosexual men.
OBJECTIVE: To assess circumcision status as a risk factor for HIV seroconversion in homosexual men. DESIGN, SETTING AND PARTICIPANTS: The Health in Men (HIM) study was a prospective cohort of homosexual men in Sydney, Australia. HIV-negative men (n = 1426) were recruited primarily from community-based sources between 2001 and 2004 and followed to mid-2007. Participants underwent annual HIV testing, and detailed information on sexual risk behaviour was collected every 6 months. MAIN OUTCOME MEASURE: HIV incidence in circumcised compared with uncircumcised participants, stratified by whether or not men predominantly practised the insertive role in anal intercourse. RESULTS: There were 53 HIV seroconversions during follow-up; an incidence of 0.78 per 100 person-years. On multivariate analysis controlling for behavioural risk factors, being circumcised was associated with a nonsignificant reduction in risk of HIV seroconversion [hazard ratio 0.78, 95% confidence interval (CI) 0.42-1.45, P = 0.424]. Among one-third of study participants who reported a preference for the insertive role in anal intercourse, being circumcised was associated with a significant reduction in HIV incidence after controlling for age and unprotected anal intercourse (UAI) (hazard ratio 0.11, 95% CI 0.03-0.80, P = 0.041). Those who reported a preference for the insertive role overwhelmingly practised insertive rather than receptive UAI. CONCLUSIONS: Overall, circumcision did not significantly reduce the risk of HIV infection in the HIM cohort. However, it was associated with a significant reduction in HIV incidence among those participants who reported a preference for the insertive role in anal intercourse. Circumcision may have a role as an HIV prevention intervention in this subset of homosexual men.
Authors: Jorge Sánchez; Victor G Sal Y Rosas; James P Hughes; Jared M Baeten; Jonathan Fuchs; Susan P Buchbinder; Beryl A Koblin; Martín Casapia; Abner Ortiz; Connie Celum Journal: AIDS Date: 2011-02-20 Impact factor: 4.177
Authors: Chris Beyrer; Stefan D Baral; Frits van Griensven; Steven M Goodreau; Suwat Chariyalertsak; Andrea L Wirtz; Ron Brookmeyer Journal: Lancet Date: 2012-07-20 Impact factor: 79.321
Authors: John A Schneider; Stuart Michaels; Sabitha R Gandham; Rachel McFadden; Chuanhong Liao; Vijay V Yeldandi; Ganesh Oruganti Journal: AIDS Behav Date: 2012-02
Authors: Brian J Morris; Robert C Bailey; Jeffrey D Klausner; Arleen Leibowitz; Richard G Wamai; Jake H Waskett; Joya Banerjee; Daniel T Halperin; Laurie Zoloth; Helen A Weiss; Catherine A Hankins Journal: AIDS Care Date: 2012-03-28
Authors: Fengyi Jin; James Jansson; Matthew Law; Garrett P Prestage; Iryna Zablotska; John C G Imrie; Susan C Kippax; John M Kaldor; Andrew E Grulich; David P Wilson Journal: AIDS Date: 2010-03-27 Impact factor: 4.177
Authors: Felisa A Gonzales; Maria Cecilia Zea; Carol A Reisen; Fernanda T Bianchi; Carlos Fabian Betancourt Rodríguez; Marcela Aguilar Pardo; Paul J Poppen Journal: Cult Health Sex Date: 2012-08-23
Authors: Stephanie L Sansom; Vimalanand S Prabhu; Angela B Hutchinson; Qian An; H Irene Hall; Ram K Shrestha; Arielle Lasry; Allan W Taylor Journal: PLoS One Date: 2010-01-18 Impact factor: 3.240