Naval Health Research Center Prevalence of Circumcision and Its Association with Hiv and Sexually Transmitted Infections in a Male U.s. Navy Population

Objectives: To determine circumcision prevalence and its association with HIV and STI in a male United States military population. Design: Case-control study of HIV-infected U.S. military personnel (n = 232) from 7 military medical centers and male U.S. Navy controls (n = 516) from an aircraft carrier. Methods: Cases and controls completed similar self-administered HIV behavioral risk surveys. Case circumcision status was abstracted from medical charts while control status was reported on the survey. Cases and controls were frequency matched on age. Multiple logistic regressions were constructed separately to evaluate the role of circumcision in the acquisition of HIV and STI. Results: Cases (84.9%) and controls (81.8%) reported similar proportions of circumcision. Prevalence of circumcision among United States-born men was higher (85.0%) than those born elsewhere (58.1%). After adjustment for demographic and behavioral risk factors, lack of circumcision was not found to be a risk factor for HIV (OR = 0.9; 95% CI, 0.51–1.7) or STI (OR = 1.08; 95% CI, 0.52–2.26). The odds of HIV infection were 2.6 higher for irregular condom users, 5 times higher for those reporting STI, 6.2 times higher for those reporting anal sex, 2.8–3.2 times higher for those with 27+ partners, nearly 3 times higher for Blacks, and 3.5 times higher for men who were single or divorced/separated. Conclusions: Although known HIV risk factors were found to be associated with HIV in this military population, there was no significant association with male circumcision. Randomized clinical trials currently underway should shed more light on this pressing topic. Circumcision and HIV/STI association 3