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AIDS and Behavior

, Volume 16, Issue 2, pp 350–359 | Cite as

A Protective Effect of Circumcision Among Receptive Male Sex Partners of Indian Men Who Have Sex with Men

  • John A. SchneiderEmail author
  • Stuart Michaels
  • Sabitha R. Gandham
  • Rachel McFadden
  • Chuanhong Liao
  • Vijay V. Yeldandi
  • Ganesh Oruganti
Original Paper

Abstract

The role of circumcision in the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) in resource restricted regions is poorly understood. This study explored the association of circumcision with HIV seroprevalence, in conjunction with other risk factors such as marriage and sex position, for a population of MSM in India. Participants (n = 387) were recruited from six drop-in centers in a large city in southern India. The overall HIV prevalence in this sample was high, at 18.6%. Bivariate and multivariable analyses revealed a concentration of risk among receptive only, married, and uncircumcised MSM, with HIV prevalence in this group reaching nearly 50%. The adjusted odds of HIV infection amongst circumcised men was less than one fifth that of uncircumcised men [adjusted odds ratio (AOR) 0.17; 95% CI 0.07–0.46; P < 0.001]. Within the group of receptive only MSM, infection was found to be lower among circumcised individuals (AOR, 0.30, 95% CI 0.12–0.76; P < 0.05) in the context of circumcised MSM engaging in more UAI, having a more recent same sex encounter and less lubricant use when compared to uncircumcised receptive men. To further explain these results, future studies should focus on epidemiologic analyses of risk, augmented by social and sexual network analyses of MSM mixing.

Keywords

Circumcision Men who have sex with men India HIV prevention Sexual behavior 

Notes

Acknowledgments

This study was supported in part by the American Foundation for AIDS Research; Dr. Schneider was supported by the National Center for Research Resources KL2RR025000, National Institutes of Health. We would like to acknowledge the study participants for their time and contribution to the study design. We would like to thank Mithrudu for their collaboration on this project and Dr. Rajender for treating study participants who were in need.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • John A. Schneider
    • 1
    • 2
    Email author
  • Stuart Michaels
    • 3
  • Sabitha R. Gandham
    • 4
  • Rachel McFadden
    • 1
  • Chuanhong Liao
    • 2
  • Vijay V. Yeldandi
    • 4
  • Ganesh Oruganti
    • 4
  1. 1.Department of MedicineThe University of ChicagoChicagoUSA
  2. 2.Department of Health StudiesThe University of ChicagoChicagoUSA
  3. 3.National Opinion Research CenterChicagoUSA
  4. 4.SHARE-IndiaHyderabadIndia

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