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behaviors and other HIV risk factors in circumcised and uncircumcised
men in Uganda.
Bailey RC, Neema S, Othieno R.
Division of Epidemiology and Biostatistics, School of Public Health,
University of Illinois at Chicago, 60302, USA. rcbailey@uic.edu
OBJECTIVE: To study the differences in sexual practices, hygienic
behaviors, and other HIV risk factors between circumcised and uncircumcised
men. DESIGN: A cross-sectional study of men >17 years of age
selected by single stage cluster sampling in the Industrial Borough,
Mbale, Uganda. METHODS: Using a structured questionnaire, 188 circumcised
and 177 uncircumcised consenting Ugandan men were interviewed in
one of four native languages during April and May, 1997. RESULTS:
Among non-Muslims, circumcised men had a higher risk profile than
uncircumcised men in that they were more likely to drink alcohol
in conjunction with sex (odds ratio [OR], 1.86: 95% confidence interval
[CI], 1.09-3.16), to have sexual contacts with women on the first
day of meeting (OR, 2.37; 95% CI, 1.39-4.04), to have had sexual
contacts in exchange for money or gifts (OR, 2.08; 95% CI, 1.21-3.09),
to have experienced episodes of pain on urination or to have experienced
penile discharge (OR, 1.68; 95% CI, 1.07-2.64), had an earlier age
at sexual debut (15.7 versus 16.9 years), and had more extramarital
sex partners in the last year (1.13 versus 0.62). Circumcised men
also reported a preference for nonwet sex. Muslims generally had
a lower risk profile than other circumcised men except they were
less likely to have ever used a condom (OR, 0.34; 95% CI, 0.15-0.78)
or to have used a condom during the last sex encounter (OR, 0.37;
95% CI, 0.14-0.87). CONCLUSIONS: These results suggest that differences
between circumcised and uncircumcised men in their sex practices
and hygienic behaviors do not account for the higher risk of HIV
infection found among uncircumcised men. Further consideration should
be given to male circumcision as a prevention strategy in areas
of high prevalence of HIV and other sexually transmitted diseases.
Studies of the feasibility and acceptability of male circumcision
in traditionally noncircumcising societies are warranted.
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