Abstract
Male circumcision reduces HIV acquisition in men. We assessed whether foreskin surface area was associated with HIV acquisition prior to circumcision. In two randomized trials of male circumcision, the surface area of the foreskin was measured after surgery using standardized procedures. Nine hundred and sixty-five initially HIV-negative men were enrolled in a community cohort who subsequently enrolled in the male circumcision trials, provided 3920.8 person-years of observation prior to circumcision. We estimated HIV incidence per 100 person-years prior to circumcision, associated with foreskin surface area categorized into quartiles. Mean foreskin surface area was significantly higher among men who acquired HIV (43.3 cm2, standard error 2.1) compared with men who remained uninfected (36.8 cm, standard error 0.5, P = 0.01). HIV incidence was 0.80/100 person-years (8/994.9 person-years) for men with foreskin surface areas in the lowest quartile (<or =26.3 cm2), 0.92/100 person-years (9/975.3 person-years) with foreskin areas in the second quartile (26.4-35.0 cm2), 0.90/100 person-years (8/888.5 person-years) with foreskin area in the third quartile (35.2-45.5 cm2) and 2.48/100 person-years (23/926.8 person-years) in men with foreskin surfaces areas in the highest quartile (>45.6 cm2). Compared with men with foreskin surface areas in the lowest quartile, the adjusted incidence rate ratio of HIV acquisition was 2.37 (95% confidence interval 1.05-5.31) in men with the largest quartile of foreskin surface area. The risk of male HIV acquisition is increased among men with larger foreskin surface areas.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2209-2213 |
| Number of pages | 5 |
| Journal | AIDS |
| Volume | 23 |
| Issue number | 16 |
| State | Published - Oct 23 2009 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
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Foreskin surface area and HIV acquisition in Rakai, Uganda (size matters). / Kigozi, Godfrey; Wawer, Maria J; Ssettuba, Absalom; Kagaayi, Joseph; Nalugoda, Fred; Watya, Stephen; Mangen, Fred Wabwire; Kiwanuka, Noah; Bacon, Melanie C.; Lutalo, Tom; Serwadda, David; Gray, Ronald H.
In: AIDS, Vol. 23, No. 16, 23.10.2009, p. 2209-2213.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Foreskin surface area and HIV acquisition in Rakai, Uganda (size matters).
AU - Kigozi, Godfrey
AU - Wawer, Maria J
AU - Ssettuba, Absalom
AU - Kagaayi, Joseph
AU - Nalugoda, Fred
AU - Watya, Stephen
AU - Mangen, Fred Wabwire
AU - Kiwanuka, Noah
AU - Bacon, Melanie C.
AU - Lutalo, Tom
AU - Serwadda, David
AU - Gray, Ronald H
PY - 2009/10/23
Y1 - 2009/10/23
N2 - Male circumcision reduces HIV acquisition in men. We assessed whether foreskin surface area was associated with HIV acquisition prior to circumcision. In two randomized trials of male circumcision, the surface area of the foreskin was measured after surgery using standardized procedures. Nine hundred and sixty-five initially HIV-negative men were enrolled in a community cohort who subsequently enrolled in the male circumcision trials, provided 3920.8 person-years of observation prior to circumcision. We estimated HIV incidence per 100 person-years prior to circumcision, associated with foreskin surface area categorized into quartiles. Mean foreskin surface area was significantly higher among men who acquired HIV (43.3 cm2, standard error 2.1) compared with men who remained uninfected (36.8 cm, standard error 0.5, P = 0.01). HIV incidence was 0.80/100 person-years (8/994.9 person-years) for men with foreskin surface areas in the lowest quartile (45.6 cm2). Compared with men with foreskin surface areas in the lowest quartile, the adjusted incidence rate ratio of HIV acquisition was 2.37 (95% confidence interval 1.05-5.31) in men with the largest quartile of foreskin surface area. The risk of male HIV acquisition is increased among men with larger foreskin surface areas.
AB - Male circumcision reduces HIV acquisition in men. We assessed whether foreskin surface area was associated with HIV acquisition prior to circumcision. In two randomized trials of male circumcision, the surface area of the foreskin was measured after surgery using standardized procedures. Nine hundred and sixty-five initially HIV-negative men were enrolled in a community cohort who subsequently enrolled in the male circumcision trials, provided 3920.8 person-years of observation prior to circumcision. We estimated HIV incidence per 100 person-years prior to circumcision, associated with foreskin surface area categorized into quartiles. Mean foreskin surface area was significantly higher among men who acquired HIV (43.3 cm2, standard error 2.1) compared with men who remained uninfected (36.8 cm, standard error 0.5, P = 0.01). HIV incidence was 0.80/100 person-years (8/994.9 person-years) for men with foreskin surface areas in the lowest quartile (45.6 cm2). Compared with men with foreskin surface areas in the lowest quartile, the adjusted incidence rate ratio of HIV acquisition was 2.37 (95% confidence interval 1.05-5.31) in men with the largest quartile of foreskin surface area. The risk of male HIV acquisition is increased among men with larger foreskin surface areas.
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UR - http://www.scopus.com/inward/citedby.url?scp=77949420120&partnerID=8YFLogxK
M3 - Article
C2 - 19770623
AN - SCOPUS:77949420120
VL - 23
SP - 2209
EP - 2213
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 16
ER -