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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Int+AIDS+Soc
2017 ; 20
(1
): 21358
Nephropedia Template TP
gab.com Text
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English Wikipedia
Dorsal longitudinal foreskin cut is associated with reduced risk of HIV, syphilis
and genital herpes in men: a cross-sectional study in Papua New Guinea
#MMPMID28406272
Vallely AJ
; MacLaren D
; David M
; Toliman P
; Kelly-Hanku A
; Toto B
; Tommbe R
; Kombati Z
; Kaima P
; Browne K
; Manineng C
; Simeon L
; Ryan C
; Wand H
; Hill P
; Law G
; Siba PM
; McBride WJ
; Kaldor JM
J Int AIDS Soc
2017[Apr]; 20
(1
): 21358
PMID28406272
show ga
INTRODUCTION: Various forms of penile foreskin cutting are practised in Papua New
Guinea. In the context of an ecological association observed between HIV
infection and the dorsal longitudinal foreskin cut, we undertook an investigation
of this relationship at the individual level. METHODS: We conducted a
cross-sectional study among men attending voluntary confidential HIV counselling
and testing clinics. Following informed consent, participants had a face-to-face
interview and an examination to categorize foreskin status. HIV testing was
conducted on site and relevant specimens collected for laboratory-based Herpes
simplex type-2 (HSV-2), syphilis, Chlamydia trachomatis (CT), Neisseria
gonorrhoeae (NG), and Trichomonas vaginalis (TV) testing. RESULTS: Overall, 1073
men were enrolled: 646 (60.2%) were uncut; 339 (31.6%) had a full dorsal
longitudinal cut; 72 (6.7%) a partial dorsal longitudinal cut; and 14 (1.3%) were
circumcised. Overall, the prevalence of HIV was 12.3%; HSV-2, 33.6%; active
syphilis, 12.1%; CT, 13.4%; NG, 14.1%; and TV 7.6%. Compared with uncut men, men
with a full dorsal longitudinal cut were significantly less likely to have HIV
(adjusted odds ratio [adjOR] 0.25, 95%CI: 0.12, 0.51); HSV-2 (adjOR 0.60, 95%CI:
0.41, 0.87); or active syphilis (adjOR 0.55, 95%CI: 0.31, 0.96). This apparent
protective effect was restricted to men cut prior to sexual debut. There was no
difference between cut and uncut men for CT, NG or TV. CONCLUSION: In this large
cross-sectional study, men with a dorsal longitudinal foreskin cut were
significantly less likely to have HIV, HSV-2 and syphilis compared with uncut
men, despite still having a complete (albeit morphologically altered) foreskin.
The protective effect of the dorsal cut suggests that the mechanism by which male
circumcision works is not simply due to the removal of the inner foreskin and its
more easily accessible HIV target cells. Exposure of the penile glans and inner
foreskin appear to be key mechanisms by which male circumcision confers
protection.Further research in this unique setting will help improve our
understanding of the fundamental immunohistologic mechanisms by which male
circumcision provides protection, and may lead to new biomedical prevention
strategies at the mucosal level.