HIV prevalence is strongly associated with geographical variations in male circumcision and foreskin cutting in Papua New Guinea: an ecological study.

Autor:	MacLaren DJ; College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia., McBride WJ; College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia., Kelly GC; Infectious Disease Epidemiology Unit, School of Population Health, University of Queensland, Brisbane, Queensland, Australia., Muller R; Tropical Health Solutions Pty Ltd, Cairns, Queensland, Australia College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia., Tommbe R; School of Health Science, Pacific Adventist University, Port Moresby, NCD, Papua New Guinea., Kaldor JM; Public Health Intervention Research Group, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia., Vallely AJ; Public Health Intervention Research Group, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Jazyk:	angličtina
Zdroj:	Sexually transmitted infections [Sex Transm Infect] 2015 Nov; Vol. 91 (7), pp. 502-5. Date of Electronic Publication: 2015 Jun 30.
DOI:	10.1136/sextrans-2014-051970
Abstrakt:	Objective: To examine the correlation between HIV prevalence and male circumcision and other foreskin cutting practices across the four regions of Papua New Guinea (PNG). Design: An ecological substudy using unique data from an interdisciplinary research programme to evaluate the acceptability, sociocultural context and public health impact of male circumcision for HIV prevention in PNG. Methods: Published data describing (a) self-reported circumcision status by region from the 'Acceptability and Feasibility of Male Circumcision for HIV prevention in PNG' study and (b) HIV prevalence by region from PNG National Department of Health were used to correlate male circumcision and other foreskin cutting practices and HIV prevalence. Maps were constructed to visually represent variations across the four regions of PNG. Results: Regions of PNG with the highest HIV prevalence had the lowest prevalence of male circumcision and other forms of foreskin cutting and vice versa. Male circumcision and dorsal longitudinal cuts were strongly associated with HIV prevalence and able to explain 99% of the observed geographical variability in HIV prevalence in PNG (p<0.01). Conclusions: The regional prevalence of HIV infection in PNG appears to be closely correlated with the regional distribution of male circumcision and dorsal longitudinal foreskin cuts. Further research is warranted to investigate causality of this correlation as well as the potential of dorsal longitudinal cuts to confer protection against HIV acquisition in heterosexual men. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
Databáze:	MEDLINE
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