Effect of circumcision on incidence of human immunodeficiency virus type 1and other sexually transmitted diseases: A prospective cohort study of trucking company employees in Kenya

To determine the effect of circumcision status on acquisition of human immu nodeficiency virus (HIV) type 1 and other sexually transmitted diseases, a prospective cohort study of 746 HIV-1-seronegative trucking company employe es was conducted in Mombasa, Kenya. During the course of follow-up, 43 men acquired HIV-1 antibodies, yielding an annual incidence of 3.0%. The annual incidences of genital ulcers and urethritis were 4.2% and 15.5%, respectiv ely. In multivariate analysis, after controlling for demographic and behavi oral variables, uncircumcised status was an independent risk factor for HIV -1 infection (hazard rate ratio [HRR] = 4.0; 95% confidence interval [CI], 1.9-8.3) and genital ulcer disease (HRR = 2.5; 95% CI, 1.1-5.3). Circumcisi on status had no effect on the acquisition of urethral infections and genit al warts. In this prospective cohort of trucking company employees, uncircu mcised status was associated with increased risk of HIV-1 infection and gen ital ulcer disease, and these effects remained after controlling for potent ial confounders.