Male circumcision and risk of HIV-1 and other sexually transmitted infections in India
Reynolds, S.J.; Shepherd, M.E.; Risbud, A.R.; Gangakhedkar, R.R.; Brookmeyer, R.S.; Divekar, A.D.; Mehendale, S.M.; Bollinger, R.C.
Lancet 363(9414): 1039-1040
2004
ISSN/ISBN: 1474-547X PMID: 15051285 DOI: 10.1016/s0140-6736(04)15840-6Document Number: 251068
Circumcised men have a lower risk of HIV-1 infection than uncircumcised men. Laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. However, some data suggest that circumcision could simply be a marker for low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0.15; 95% CI 0.04-0.62; p=0.0089); however, we noted no protective effect against herpes simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1.
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