番茄社区

PARIS – South African women whose male partners were circumcised had a reduced risk of contracting HIV infection, researchers reported here at the International AIDS Society Conference on HIV Science.

While circumcision has been known to protect men in high prevalent regions from contracting HIV, the new study indicates that a woman whose most recent sexual partner had been circumcised was 22% less likely to have HIV, said Ayesha Kharsany, PhD, of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and the University of KwaZulu, Durban.

Kharsany also said that women whose most recent sexual partner had been circumcised were 15% less likely to have genital herpes.

She said the "real world" HIV Incidence Provincial Surveillance System analyses is the first evidence to illustrate that circumcision provides community-level protection against HIV and other sexually-transmitted diseases among women. It supports previous studies suggesting women were partially protected against transmission of HIV when their partner was circumcised.

"Our findings are that male circumcision being done to protect men from HIV infection also protects women against HIV," said Kharsany at a press conference.

Data from the surveillance system – set up to monitor HIV infection rates as treatment was scaled up in South Africa – were collected from June 2014 to June 2015 and included 9,812 participants. There were 6,262 women in the surveillance system and 3,547 men.

From that database, the researchers randomly selected 4,766 women. Women with circumcised partners had similar numbers of lifetime partners – a mean of 2.45 partners -- to those with uncircumcised partners, a mean of 2.71 partners.

In the younger stratum -- ages 15 to 25 -- partner circumcision was negatively associated with HIV. About 24% of these women in this group who had circumcised partners had HIV compared with 35% of women who had a non-circumcised partner, a statistically significant difference (P<0.01). Kharsany also reported that these younger women with circumcised male partners had a 49% rate of genital herpes virus compared with 62% of women who had uncircumcised partners (P<0.01).

Among the older women -- up to age 49 in this study -- partner circumcision was negatively associated with syphilis. Those women whose last sexual partner was circumcised had a syphilis rate of 1.5% compared with a rate of 3.4% (P=0.04) among women whose last sexual partner was not circumcised. The genital herpes rate was 83% among women whose last sexual partner was circumcised and was 86% in women whose last sexual partner was not circumcised (P=0.04). However, these women in the older cohort whose last sexual partner was circumcised were more likely to have ever had a sexually transmitted disease (11%) compared to women whose partners were not circumcised (7%, P<0.01), Kharsany said.

She suggested that women may be protected against HIV infections due to the community effect of the rollout of circumcision programs in which more than 12 million men have undergone the procedure in the last decade, following studies showing that circumcision did reduce the risk that men would contract HIV. She said there also may be something about circumcision that makes men less likely to transmit the disease.

"The advantages of male circumcision to protect the male partner from HIV infection is well documented," said Linda-Gail Bekker, MBChB, PhD, president of the International AIDS Society and professor of medicine at the University of Cape Town. "What is interesting here is that the protection against HIV is extended to the female partners against HIV by circumcised men."

Addressing the undercurrent of anti-circumcision activism in the United States, Bekker told 番茄社区, "I don't think there is any harm in circumcision. If it is done safely and in the right medical environment and using the proper tools for the surgery, I have not seen any evidence of harm. As we heard, 12 million men have been circumcised in this program, so I feel strongly that this is something of great benefit. It is a one-off procedure that continues to bring dividends – and seemingly for both men and women.

"We have to continue to watch for the results on the Women's side. This was an observational study, but hopefully it will continue to pay out," said Bekker, who moderated the press conference.

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