Risk Compensation Is Not Associated with Male Circumcision in Kisumu, Kenya A Multi-Faceted？Assessment？of Men Enrolled in a Randomized Controlled Trial 英文参考文献.docVIP

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Risk Compensation Is Not Associated with Male Circumcision in Kisumu, Kenya A Multi-Faceted？Assessment？of Men Enrolled in a Randomized Controlled Trial 英文参考文献.doc

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Risk Compensation Is Not Associated with Male Circumcision in Kisumu, Kenya A Multi-Faceted？Assessment？of Men Enrolled in a Randomized Controlled Trial 英文参考文献

RiskCompensationIsNotAssociatedwithMale CircumcisioninKisumu,Kenya:AMulti- FacetedAssessmentofMenEnrolledinaRandomized ControlledTrial ChristineL.Mattson1*,RichardT.Campbell1,RobertC.Bailey1,KawangoAgot2,J.O.Ndinya-Achola3, StephenMoses4 1School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America, 2UNIM Project, Kisumu, Kenya, 3Department of Medical Microbiology,UniversityofNairobi,Nairobi,Kenya,4DepartmentofMedicalMicrobiology,UniversityofManitoba,Winnipeg,Canada Abstract Background:Threerandomizedcontrolledtrials(RCTs)haveconfirmedthatmalecircumcision(MC)significantlyreduces acquisition of HIV-1 infection among men. The objective of this study was to perform a comprehensive, prospective evaluationofriskcompensation,comparingcircumcisedversusuncircumcisedcontrolsinasampleofRCTparticipants. MethodsandFindings:BetweenMarch2004andSeptember2005,wesystematicallyrecruitedmenenrolledinaRCTofMC in Kenya. Detailed sexual histories were taken using a modified Timeline Followback approach at baseline, 6, and 12 months.ParticipantsprovidedpermissiontoobtaincircumcisionstatusandlaboratoryresultsfromtheRCT.Weevaluated circumcisedanduncircumcisedmen’ssexualbehaviorusingan18-itemrisk propensityscoreandacquisitionofincident infections of gonorrhea, chlamydia, and trichomoniasis. Of 1780 eligible RCT participants, 1319 enrolled (response rate=74%).AtthebaselineRCTvisit,menwhoenrolledinthesub-studyreportedthesamesexualbehaviorsasmenwho didnot.We foundasignificantreduction in sexualrisk behavioramongboth circumcised anduncircumcised menfrom baselineto6(p,0.01)and12(p=0.05)monthspost-enrollment.Longitudinalanalysesindicatednostatisticallysignificant differences between sexual risk propensity scores or in incident infections of gonorrhea, chlamydia, and trichomoniasis between circumcised and uncircumcised men. These results are based on the most comprehensive analysis of risk compensationyetdone. Conclusion:InthecontextofaRCT,circum