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Marlena Gehret,
Stephanie
Skoler, Sarah Littlefield,
Barbara
Friedland, Alana de Kock, J. Skhosana, Nela Williams, and
Thesla Palanee. "Correlation between male partner
circumcision and HIV prevalence amongst screened participants in the
Phase 3 Carraguard® microbicide trial." (Poster no. B28)
ABSTRACT
Background and objectives
Research shows that male circumcision reduces male risk of HIV
infection, however, it is not known whether male circumcision
protects female partners from HIV. To explore this topic, we
reviewed the correlation between male partner circumcision
status and HIV prevalence in the screening population of a Phase
3 efficacy trial of the Carraguard® microbicide. The trial is
being implemented by the University of Cape Town (UCT), the
University of Limpopo/Medunsa campus near Pretoria, and the
Medical Research Council (MRC) near Durban.
Method
Baseline data were collected for 9,353 of women screened for the
study. At screening, women are tested for HIV and interviewed
about sexual behavior, including a question about (main)
partner circumcision. HIV serostatus at screening was compared
with reported partner circumcision.
Results
Reported circumcision was inversely proportional to HIV
prevalence—circumcision was 97 percent at UCT, 53 percent at Medunsa, and 25
percent
at MRC. The HIV prevalence was 18 percent at UCT, 24 percent at Medunsa, and
42 percent at MRC. (Partner circumcision status was unknown by 24
percent at MRC, <1 percent at UCT, and 7 percent at Setshaba.)
However, when partner circumcision and HIV serostatus were
examined at the individual level at each site, the odds ratio
did not indicate an association: At Medunsa the OR was 0.90;
1.12 at MRC, and 1.62 at UCT (but the number of uncircumcised
partners at UCT was very small).
Most women reported only one partner in the past month.
Controlling for number of partners did not significantly change
the findings.
Conclusion
It is plausible that the high prevalence of male circumcision in
Cape Town may contribute to its lower HIV prevalence rate. At
MRC, where circumcision is less common, HIV prevalence is
highest. Additional research is recommended to determine whether
circumcising HIV-positive men reduces the risk of transmission
to female partners.
3rd South African AIDS Conference Web site
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