Risk of HIV-1 in rural Kenya: a comparison of circumcised and uncircumcised men

Epidemiology. 2004 Mar;15(2):157-63. doi: 10.1097/01.ede.0000112220.16977.82.


Background: Most studies that have found an association between uncircumcised status and infection with human immunodeficiency virus type 1 (HIV-1) have compared participants from various demographic backgrounds, among which the prevalence of other risk factors might have varied. We report findings from a study conducted among men within a single ethnic community in which circumcision was dictated by the religious denomination to which the men belonged.

Methods: Of the 1217 eligible men, we included in the analysis 845 who gave blood samples for HIV-1 testing and who were confirmed as either fully circumcised (n = 398) or uncircumcised (n = 447). The seroprevalence of HIV-1 was compared between the 2 groups.

Results: All correlates of HIV-1 prevalence that we measured were distributed similarly between circumcised and uncircumcised men. The seroprevalence of HIV-1 was 30% among the uncircumcised men and 20% among the circumcised men. Among uncircumcised men, HIV-1 seroprevalence was similar between men from circumcising denominations (31%; n = 111) and noncircumcising denominations (30%; n = 336). The crude prevalence ratio for HIV infection associated with not being circumcised was 1.5 (95% confidence interval = 1.2-2.0); and adjustment for other measured risk factors for HIV-1 infection had little impact on this result.

Conclusion: Our study provides evidence that circumcision is associated with a reduced risk of HIV-1 infection.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Circumcision, Male*
  • Cross-Sectional Studies
  • Data Collection
  • Enzyme-Linked Immunosorbent Assay
  • HIV Seroprevalence*
  • HIV-1*
  • Humans
  • Kenya / epidemiology
  • Male
  • Middle Aged
  • Risk Factors
  • Rural Health
  • Sexual Behavior*