NDLI: Men's circumcision status and women's risk of HIV acquisition in Zimbabwe and Uganda.

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Men's circumcision status and women's risk of HIV acquisition in Zimbabwe and Uganda.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Turner, Abigail Norris Morrison, Charles S. Padian, Nancy S. Kaufman, Jay S. Salata, Robert A. Chipato, Tsungai Mmiro, Francis A. Mugerwa, Roy D. Behets, Frieda M. Miller, William C.
Spatial Coverage	Uganda Zimbabwe
Description	Country affiliation: United States Author Affiliation: Turner AN ( Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. ant@unc.edu)
Abstract	OBJECTIVE: To assess whether male circumcision of the primary sex partner is associated with women's risk of HIV. DESIGN: Data were analyzed from 4417 Ugandan and Zimbabwean women participating in a prospective study of hormonal contraception and HIV acquisition. Most were recruited from family planning clinics; some in Uganda were referred from higher-risk settings such as sexually transmitted disease clinics. METHODS: Using Cox proportional hazards models, time to HIV acquisition was compared for women with circumcised or uncircumcised primary partners. Possible misclassification of male circumcision was assessed using sensitivity analysis. RESULTS: At baseline, 74% reported uncircumcised primary partners, 22% had circumcised partners and 4% had partners of unknown circumcision status. Median follow-up was 23 months, during which 210 women acquired HIV (167, 34, and 9 women whose primary partners were uncircumcised, circumcised, or of unknown circumcision status, respectively). Although unadjusted analyses indicated that women with circumcised partners had lower HIV risk than those with uncircumcised partners, the protective effect disappeared after adjustment for other risk factors [hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.69-1.53]. Subgroup analyses suggested a non-significant protective effect of male circumcision on HIV acquisition among Ugandan women referred from higher-risk settings: adjusted HR 0.16 (95% CI, 0.02-1.25) but little effect in Ugandans (HR, 1.33; 95% CI, 0.72-2.47) or Zimbabweans (HR, 1.12; 95% CI, 0.65-1.91) from family planning clinics. CONCLUSIONS: After adjustment, male circumcision was not significantly associated with women's HIV risk. The potential protection offered by male circumcision for women recruited from high-risk settings warrants further investigation.
File Format	HTM / HTML
ISSN	02699370
e-ISSN	14735571
Journal	AIDS
Issue Number	13
Volume Number	21
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2007-08-20
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Immunology Circumcision, Male Statistics & Numerical Data Hiv Infections Prevention & Control Adolescent Epidemiologic Methods Epidemiology Transmission Sexual Behavior Uganda Zimbabwe Multicenter Study Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Immunology and Allergy Immunology

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