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Associations Between Early Circumcision, Sexual and Protective Practices, and HIV Among a National Sample of Male Adults in Eswatini

Asociación entre circuncisión a temprana edad, practicas sexuales y VIH en una muestra nacional de hombres adultos en Eswatini

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Abstract

To reduce HIV incidence in countries such as Eswatini (Swaziland), UNAIDS has recommended male circumcision as one possible effective strategy. We analyzed the 2016s Swaziland HIV Incidence Measurement Survey to explore the association between early circumcision and HIV history among 2964 sexually active adult males aged 15 to 64 years old. Early circumcision was defined as circumcision practiced at an age of 15 years old or younger. Results from logistic regression and OLS regression found that male adults with early circumcision are more likely to have multiple sexual partners and to use condoms. Multiple partners and condom use at last sex encounter remained associated with a higher odds of being HIV positive after controlling for all factors. Nevertheless, early circumcision is significantly associated with a lower odds of being HIV positive (AOR 0.53, p < 0.01). These findings suggest that HIV prevention may benefit when early male circumcision is carried out.

Resumen

Con el objetivo de reducir la incidencia de VIH en países como Eswatini (Suazilandia), UNAIDS ha recomendado la práctica de la circuncisión como una estrategia efectiva con este fin. A partir del análisis de la Encuesta de Medición de la Incidencia del VIH en Suazilandia (SHIMS 2), la presente investigación tiene como objetivo explorar la asociación entre la circuncisión a edad temprana (practicada a la edad de 15 años o menos) y la infección por el VIH en 2,964 hombres adultos que son sexualmente activos con edades comprendidas entre 15 y 64 años. Mediante la regresión logística y de mínimos cuadrados ordinarios (ordinary least squares), se encontró que los hombres circuncidados a temprana edad tienden más a tener múltiples parejas sexuales y a usar preservativos. El uso de preservativos en la última relación sexual y el hecho de tener múltiples parejas sexuales permaneció asociado con la infección por el VIH tras ajustar por factores de confusión. La circuncisión a temprana edad se asoció con un menor riesgo de infección por el VIH (OR ajustado=0.53, p<0.01). Estos resultados sugieren que la circuncisión a edad temprana debería tenerse en cuenta como estrategia de prevención del VIH.

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Acknowledgements

We thank the Editor and reviewers for their constructive comments for the improvement in the quality of this paper. This study was funded by Ministry of Science and Technology in Taiwan under Grant 107-2511-H-010-001-MY2. The conclusions herein are those of the authors and do not represent the viewpoint of the Ministry. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. International Health Program, Institute of Public Health, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

    Bongani Zakhele Masango & Chi Chiao

  2. HIV Program (HIV Prevention), Eswatini Ministry of Health, Mbabane, Eswatini

    Bongani Zakhele Masango

  3. Public Health Surveillance and Emergency Response Department of Vallès Occidental and Vallès Oriental, Public Health Agency of Catalonia, Sant Cugat del Vallès, Barcelona, Spain

    David Ferrandiz-Mont

  4. Institute of Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

    Chi Chiao

  5. Institute of Health and Institute of Public Health, College of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei, 112, Taiwan, ROC

    Chi Chiao

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  1. Bongani Zakhele Masango
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  2. David Ferrandiz-Mont
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Correspondence to Chi Chiao.

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Masango, B.Z., Ferrandiz-Mont, D. & Chiao, C. Associations Between Early Circumcision, Sexual and Protective Practices, and HIV Among a National Sample of Male Adults in Eswatini. AIDS Behav 25, 973–982 (2021). https://doi.org/10.1007/s10461-020-03056-0

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