与男性发生性关系的男性中预防艾滋病毒的割礼:更新的元分析
Stephanie M Davis1, Ian Fellows1, Oscar de Leon1
1Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention 1600 Clifton Rd NE, Atlanta 30333, USA.
Journal of acquired immune deficiency syndromes (1999)
|February 23, 2026
概括
男人割礼显著保护与男性发生性关系的主要插入性男性 (PI-MSM) 免受艾滋病毒感染. 这一发现支持男性割礼作为这一群体的关键艾滋病毒预防策略.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 预防传染病 预防传染病
背景情况:
- 已知男性割礼可以降低异性恋男性的艾滋病毒风险,但由于数据不一致,其对与男性发生性关系的男性 (MSM) 的影响尚不清楚.
- 之前对MSM的研究因区域差异而混,缺乏强有力的证据,尽管最近的一项试验表明,在主要插入性MSM (PI-MSM) 中具有保护性.
研究的目的:
- 澄清男性割礼与艾滋病毒风险之间的关联,特别是在PI-MSM中.
- 进行严格的元分析,调整混因素,以确定割礼在这个人群中的保护作用.
主要方法:
- 一项更新的文献搜索确定了49项用于描述性分析的研究.
- 进行了随机效应元分析,首先没有调整,然后调整了混因素,比较PI-MSM与其他MSM的HIV风险.
- 评估了出版偏见和区域异质性,以确保研究结果的有效性.
主要成果:
- 未经调整的元分析显示PI-MSM (OR=0.57) 中的割礼减少了艾滋病毒风险,尽管有偏差和异质.
- 经过混调整的元分析显示,割礼对PI-MSM具有显著的保护作用 (OR比率=0.53),没有显著的出版偏差或区域异质.
- 十项研究为混调整后的元分析做出了贡献,提供了强有力的证据.
结论:
- 男性割礼在PI-MSM中显示出对抗艾滋病毒感染的显著保护作用.
- 这些发现强烈支持实施男性割礼作为PI-MSM有效的HIV预防策略.
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