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Postcoital penile washing and the risk of HIV acquisition in uncircumcised men
Fredrick E Makumbi1, Victor Ssempijja, Joseph Sekasanvu
1aMakerere University, School of Public Health, College of Health Sciences, Kampala bRakai Health Sciences Program, Entebbe, Uganda cDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Background:
Postcoital genital washing by uncircumcised men may affect the risk of male HIV acquisition.
Method:
We assessed the association between self-reported washing after sex in 2976 initially HIV-negative, uncircumcised men enrolled in a prospective cohort study in Rakai, Uganda.
Results:
Data from the 2976 participants who reported sexual intercourse in the past 12 months contributed 4290 visits, with 7316.6 person-years of observation during the 2-year follow-up. The overall HIV-incidence was 1.28/100 person-years 95%CI (1.04-1.57). About 91.0% of men reported washing their penis after sex, and their HIV incidence was 1.34/100 person-years (95%CI 1.08-1.66), compared with an incidence of 0.62/100 person-years (95%CI 0.17-1.60) in men who did not wash their penis after intercourse. Using Poisson multivariable regression, the adjusted incidence rate ratio of HIV acquisition associated with postcoital washing was 1.94 (95%CI 0.71-5.29).
Conclusion:
Postcoital penile washing, as practiced in this rural African population does not afford protection from HIV acquisition among uncircumcised men, and may increase risk.
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