XV International AIDS Conference, Bangkok, Thailand,
July 11-16, 2004.

Prevalence of male circumcision and its association with HIV
and sexually transmitted infections in a U.S. navy population

A G Thomas, L N Bakhireva, S K Brodine, R A Shaffer


Background: Lack of male circumcision has been found to be a risk factor for HIV and sexually transmitted infection (STI) in several studies performed in developing countries. However, the few studies conducted in developed nations have yielded inconsistent results. Policy regarding circumcision of male infants as a prevention measure against HIV/STI remains a controversial topic. This study describes the prevalence of circumcision and its association with HIV and STI in a U.S. military population.

Methods: This is a case-control study of male HIV infected U.S. military personnel (n= 232) recruited from 7 military medical centers and male U.S. Navy controls (n=516) from a general aircraft carrier population. Cases and controls completed similar self-administered HIV behavioral risk surveys. Case circumcision status was abstracted from medical charts while control status was reported on the survey. Cases and controls were frequency matched on age. Multiple logistic regressions were constructed separately to evaluate the role of circumcision in the acquisition of HIV and STI.

Results: The proportion of circumcised men did not significantly differ between cases (84.9%) and controls (81.8%). Prevalence of circumcision among men born in the U.S. was higher (85.0%) than those born elsewhere (58.1%). After adjustment for demographic and behavioral risk factors lack of circumcision was not found to be a risk factor for HIV (OR = 0.9; 95% CI: 0.51, 1.7) or STI (OR = 1.08; 95% CI 0.52, 2.26). The odds of HIV infection were 2.6 higher for irregular condom users, 5 times as high for those reporting STI, 6.2 times higher for those reporting anal sex, 2.8-3.2 times higher for those with 2-7+ partners, nearly 3 times higher for Blacks, and 3.5 times as high for men who were single or divorced/separated.

Conclusions: Although there may be other medical or cultural reasons for male circumcision, it is not associated with HIV or STI prevention in this U.S. military population.

Naval Health Research Center, DHAPP
P.O. Box 85122
San Diego, CA, United States

[CIRP Comment: This study found that 84.9 percent of infected males were circumcised as compared with 81.8 percent of non-infected men were circumcised. This difference (3.1%) may not be statistically significance, however, it does show a higher percentage of circumcised males among those who are infected.]

(File revised 24 November 2006)