Increased risk of infection with human immunodeficiency virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya

Clin Infect Dis. 1996 Sep;23(3):449-53. doi: 10.1093/clinids/23.3.449.


The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chancroid / complications
  • Circumcision, Male* / statistics & numerical data
  • Cross-Sectional Studies
  • Genital Diseases, Male / complications*
  • Genital Diseases, Male / microbiology
  • HIV Infections / epidemiology*
  • HIV Infections / transmission
  • HIV-1*
  • Haemophilus ducreyi / isolation & purification
  • Humans
  • Kenya / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • Skin Ulcer / complications*
  • Skin Ulcer / microbiology