INCREASED RISK OF INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 AMONG UNCIRCUMCISED MEN PRESENTING WITH GENITAL ULCER DISEASE IN KENYA

The factors responsible for the explosive spread of human immunodefici ency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identif ied and debated. One of the most controversial factors has been male c ircumcision. This cross-sectional study was conducted to measure the a ssociation 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 regre ssion model adjusted for behavioral and historical factors showed that HIV-1 positivity was independently associated with being uncircumcise d (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 sexu al exposure to HIV-1 among this population. Male circumcision should b e considered as an intervention strategy for AIDS control.