Male genital hygiene affects risk of HIV infection
By, Reuters health, September 22, 2006
NEW YORK (Reuters Health) - Washing the penis regularly lowers the risk of HIV infection in circumcised and uncircumcised men, according to two papers in the Journal of Acquired Immune Deficiency Syndromes for September.
Male circumcision is associated with a reduced prevalence of HIV, according to Dr. Nigel O'Farrell, from Ealing Hospital in London, and colleagues. They now suggest that interventions to improve genital hygiene may also be effective in reducing HIV infection risk.
Specifically, they theorized that the presence of subpreputial penile wetness would increase risk, and that washing to keep the area under the foreskin dry would reduce risk. They define penile wetness as "the observation of a diffuse homogenous film of moisture on the surface of the glans and coronal sulcus."
Their study included 386 uncircumcised men residing in or near Durban, South Africa, who were free of genital ulceration or urethral discharge. Clinicians who examined the men observed that half had some degree of wetness around the glans and coronal sulcus. Approximately 80% were judged to be slightly wet, 19% as wet, and 2% as very wet.
In contrast, only one of 36 circumcised men they examined had wetness.
Factors associated with penile wetness were younger age, low level of attained education, low income, higher lifetime numbers of sexual partners and not washing after sex.
The prevalence of HIV infection was 66.3% among men with penile wetness, versus 45.9% in those with no wetness. After adjusting for HIV predictors and confounders, the adjusted odds ratio (OR) for HIV infection was 2.27 when comparing men with wetness versus those who were dry. The degree of wetness did not affect the risk.
The authors note that the HIV prevalence among uncircumcised men without penile wetness was close to that of circumcised men (42.9%).
Although many of the factors associated with penile wetness were poverty-related, Dr. O'Farrell's group suggests that "information, education, and communication programs at a number of levels would be needed: for instance, encouraging washing related to sexual activity -- precoital or postcoital or as an everyday life skill."
In the second Journal report, Dr. King K. Holmes, from Harborview Medical Center in Seattle, and associates interviewed 150 men living in Kenya regarding socioeconomic status and hygiene practices; 15% were HIV positive, and 97% were circumcised.
Components of hygiene associated with risk included amount of time spent in a bath (more than 10 minutes) and bathing immediately after sex.
Multivariate analysis revealed three independent risk factors for HIV infection: previous treatment for a serious illness (OR = 5.1, p = 0.02), circumcision (OR = 0.12, p = 0.04) and genital hygiene (OR = 0.41, p = 0.03).
Source: http://www.aidsmeds.com/news/20060922publ002.html
NEW YORK (Reuters Health) - Washing the penis regularly lowers the risk of HIV infection in circumcised and uncircumcised men, according to two papers in the Journal of Acquired Immune Deficiency Syndromes for September.
Male circumcision is associated with a reduced prevalence of HIV, according to Dr. Nigel O'Farrell, from Ealing Hospital in London, and colleagues. They now suggest that interventions to improve genital hygiene may also be effective in reducing HIV infection risk.
Specifically, they theorized that the presence of subpreputial penile wetness would increase risk, and that washing to keep the area under the foreskin dry would reduce risk. They define penile wetness as "the observation of a diffuse homogenous film of moisture on the surface of the glans and coronal sulcus."
Their study included 386 uncircumcised men residing in or near Durban, South Africa, who were free of genital ulceration or urethral discharge. Clinicians who examined the men observed that half had some degree of wetness around the glans and coronal sulcus. Approximately 80% were judged to be slightly wet, 19% as wet, and 2% as very wet.
In contrast, only one of 36 circumcised men they examined had wetness.
Factors associated with penile wetness were younger age, low level of attained education, low income, higher lifetime numbers of sexual partners and not washing after sex.
The prevalence of HIV infection was 66.3% among men with penile wetness, versus 45.9% in those with no wetness. After adjusting for HIV predictors and confounders, the adjusted odds ratio (OR) for HIV infection was 2.27 when comparing men with wetness versus those who were dry. The degree of wetness did not affect the risk.
The authors note that the HIV prevalence among uncircumcised men without penile wetness was close to that of circumcised men (42.9%).
Although many of the factors associated with penile wetness were poverty-related, Dr. O'Farrell's group suggests that "information, education, and communication programs at a number of levels would be needed: for instance, encouraging washing related to sexual activity -- precoital or postcoital or as an everyday life skill."
In the second Journal report, Dr. King K. Holmes, from Harborview Medical Center in Seattle, and associates interviewed 150 men living in Kenya regarding socioeconomic status and hygiene practices; 15% were HIV positive, and 97% were circumcised.
Components of hygiene associated with risk included amount of time spent in a bath (more than 10 minutes) and bathing immediately after sex.
Multivariate analysis revealed three independent risk factors for HIV infection: previous treatment for a serious illness (OR = 5.1, p = 0.02), circumcision (OR = 0.12, p = 0.04) and genital hygiene (OR = 0.41, p = 0.03).
Source: http://www.aidsmeds.com/news/20060922publ002.html
posted by AIDS-Care-Watch at 4:12 pm
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