Format

Send to

Choose Destination
J Acquir Immune Defic Syndr. 2016 Apr 1;71(4):444-51. doi: 10.1097/QAI.0000000000000856.

Lower HIV Risk Among Circumcised Men Who Have Sex With Men in China: Interaction With Anal Sex Role in a Cross-Sectional Study.

Author information

1
*Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN; †Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN; ‡Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China; §State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; ‖Department of Urology, Vanderbilt University School of Medicine, Nashville, TN; ¶HJF-DAIDS, a Division of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Contractor to National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD; #Chaoyang District Center for Disease Control and Prevention, Beijing, China; Departments of **Biostatistics; and ††Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.

Abstract

BACKGROUND:

Voluntary medical male circumcision reduces the risk of HIV heterosexual transmission in men, but its effect on male-to-male sexual transmission is uncertain.

METHODS:

Circumcision status of men who have sex with men (MSM) in China was evaluated by genital examination and self-report; anal sexual role was assessed by questionnaire interview. Serostatus for HIV and syphilis was confirmed.

RESULTS:

Among 1155 participants (242 were seropositive and 913 with unknown HIV status at enrollment), the circumcision rate by self-report (10.4%) was higher than confirmed by genital examination (8.2%). Male circumcision (by examination) was associated with 47% lower odds of being HIV seropositive [adjusted odds ratio (aOR): 0.53; 95% confidence interval (CI): 0.27 to 1.02] after adjusting for demographic covariates, number of lifetime male sexual partners, and anal sex role. Among MSM who predominantly practiced insertive anal sex, circumcised men had 62% lower odds of HIV infection than those who were uncircumcised (aOR: 0.38; 95% CI: 0.09 to 1.64). Among those whose anal sex position was predominantly receptive or versatile, circumcised men have 46% lower odds of HIV infection than did men who were not circumcised (aOR: 0.54; 95% CI: 0.25 to 1.14). Compared to uncircumcised men reporting versatile or predominantly receptive anal sex positioning, those who were circumcised and reported practicing insertive sex had an 85% lower risk (aOR: 0.15; 95% CI: 0.04 to 0.65). Circumcision was not associated clearly with lower syphilis risk (aOR: 0.91; 95% CI: 0.51 to 1.61).

CONCLUSIONS:

Circumcised MSM were less likely to have acquired HIV, most pronounced among men predominantly practicing insertive anal intercourse. A clinical trial is needed.

PMID:
26413852
PMCID:
PMC4767598
DOI:
10.1097/QAI.0000000000000856
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wolters Kluwer Icon for PubMed Central
Loading ...
Support Center