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CSU 19/2010: NOTE TO READERS/ MALE CIRCUMCISION AND RISK OF HIV INFECTIO AMONG HETEROSEXUAL AFRICAN AMERICAN MEN‏

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Dear All,
  
Note to Readers
 
Please see the attached, especially pages 8 and 9, for terms of reference for work with routine EPI in Nigeria Any qualified persons should apply to the Email address listed below, no copy to this address.
 

Hugues TEMPLE-BOYER

Project Director

Conseil Santé

92-98, Bld Victor Hugo

92110 Clichy, France

htb@conseilsante.com

 
 
 
1) Male Circumcision and Risk of HIV Infection among Heterosexual African American Men
 
The generalizability to industrialized countries of the results of the three African RCTs on male circumcision and risk of HIV acquisition in heterosexual males remains a controversial topic. Here are the conclusions of one study from Baltimore: "Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the US context."
 
Good reading.
 
BD
 

 
The Journal of Infectious Diseases 2009;199:59–65
© 2008 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2009/19901-0009$15.00
DOI: 10.1086/595569
MAJOR ARTICLE

Male Circumcision and Risk of HIV Infection among Heterosexual African American Men Attending Baltimore Sexually Transmitted Disease Clinics

Lee Warner,1

Khalil G. Ghanem,4

Daniel R. Newman,1,2

Maurizio Macaluso,1

Patrick S. Sullivan,3,a and

Emily J. Erbelding4,5

Divisions of 1Reproductive Health, 2Sexually Transmitted Disease Prevention, and 3HIV/AIDS Prevention–Surveillance and Epidemiology, Centers for Disease Control and Prevention, Atlanta, Georgia; 4Division of Infectious Diseases, Johns Hopkins University School of Medicine, and 5Baltimore City Health Department, Baltimore, Maryland.

Background.Male circumcision has received international attention as an intervention for reducing HIV infection among highâ€risk heterosexual men; however, few US studies have evaluated its association with the risk of HIV infection.

Methods.We analyzed visit records for heterosexual African American men who underwent HIV testing while attending sexually transmitted disease (STD) clinics in Baltimore, Maryland, from 1993 to 2000. We used multivariable binomial regression to evaluate associations between circumcision and the risk of HIV infection among visits by patients with known and unknown HIV exposure.

Results.Overall, 1096 (2.7%) of 40,571 clinic visits yielded positive HIV test results. Among 394 visits by patients with known HIV exposure, circumcision was significantly associated with lower HIV prevalence (10.2% vs. 22.0%; adjusted prevalence rate ratio [PRR], 0.49 [95% confidence interval [CI], 0.26–0.93]). Conversely, among 40,177 visits by patients with unknown HIV exposure, circumcision was not associated with reduced HIV prevalence (2.5% vs. 3.3%; adjusted PRR, 1.00 [95% CI, 0.86–1.15]), and age 25 years old and diagnosis of ulcerative STD were associated with increased prevalence.

Conclusions.Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the US context.

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