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Male Condoms and Circumcision

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AIDS in Africa

Conclusion

This chapter has examined condoms and male circumcision as HIV preventive strategies in Africa. Condoms are a highly effective method of preventing HIV when used properly, and play a central role in HIV prevention programs in Africa. Although condom use remains low in many areas of Africa, condom accessibility and use can be improved dramatically through creative and culturally appropriate social marketing and education programs. Male circumcision may play a role in future HIV prevention programs; the weight of current evidence supports its effectiveness. However, a randomized clinical trial, as currently planned in western Kenya, may be needed to further elucidate issues of confounding and the impact of circumcision on reducing HIV transmission in the general population. Ultimately, the success of both condom promotion efforts and male circumcision programs will depend on their resonance at the local level.

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References

  1. Judson F, Ehret J, Bodin G, et al. In vitro evaluations of condoms with and without nonoxynol-9 as physical and chemical barriers against Chlamydia trachomatis, herpes simplex virus type 2, and human immunodeficiency virus. Sex Trans Dis, 1989;16:51–56.

    CAS  Google Scholar 

  2. Rietmeijer C, Krebs J, Feorino P, et al. Condoms as physical and chemical barriers against human immunodeficiency virus. JAMA, 1988;259:1851–1853.

    Article  PubMed  CAS  Google Scholar 

  3. From the Centers for Disease Control and Prevention. Update: barrier protection against HIV infection and other sexually transmitted diseases. JAMA, 1993;270:933–934.

    Google Scholar 

  4. UNAIDS Technical Update. The male condom. Geneva, Switzerland: UNAIDS, 2000.

    Google Scholar 

  5. Ngugi EN, Plummer FA, Simonsen JN, et al. Prevention of transmission of human immunodeficiency virus in Africa: effectiveness of condom promotion and health education among prostitutes. Lancet, 1988;2:887–890.

    PubMed  CAS  Google Scholar 

  6. Mann J, Quinn TC, Piot P, et al. Condom use and HIV infection among prostitutes in Zaire. New Engl. J Med, 1987;316:345.

    PubMed  CAS  Google Scholar 

  7. DeVincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New Engl J Med, 1994;331:341–346.

    CAS  Google Scholar 

  8. Bagurukira E, Kiwanuka A, Bakaki P, et al. Condom use between HIV serology discordant couples in Kampala. In: Abstracts of the XIII International Conference on AIDS; July 9–14, 2000; Durban, South Africa. Abstract ThOrD779.

    Google Scholar 

  9. Davis KR, Weller SC. The effectiveness of condoms in reducing heterosexual transmission of HIV. Fam Plann Perspect, 1999;31:272–279.

    PubMed  CAS  Google Scholar 

  10. Allen S, Tice J, Van de Perre P, et al. Effect of serotesting with counseling on condom use and seroconversion among HIV discordant couples in Africa. Br Med J, 1992;304:1605–1609.

    CAS  Google Scholar 

  11. Ndinya-Achola, Ghee AE, Kihara AN, et al. High HIV prevalence, low condom use and gender differences in sexual behaviour among patients with STD-related complaints at a Nairobi primary health care clinic. Intl J STDAIDS, 1997;8;506–514.

    CAS  Google Scholar 

  12. UNAIDS. Differences in HIV spread in four sub-Saharan African cities: summary of the multi-site study. September 14, 1999. UNAIDS website. Available at: http://www.unaids.org/whatsnew/press/eng/pressarc99/lusaka14sep99.html. Accessed: November 24, 2001.

  13. Colvin M, Sharp B. Sexually transmitted infections and HIV in a rural community in the Lesotho highlands. Sex Transm Infect, 2000;76:39–42.

    PubMed  CAS  Google Scholar 

  14. Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. New Engl J Med, 2000;342:921–929.

    Article  PubMed  CAS  Google Scholar 

  15. Laga M, Alary M, Nzila N, et al. Condom promotion, sexually transmitted diseases treatment, and declining incidence of HIV-1 infection in female Zairian sex workers. Lancet, 1994;344:246–248.

    Article  PubMed  CAS  Google Scholar 

  16. Allen S, Serufilira A, Bogaerts J, et al. Confidential HIV testing and condom promotion in Africa: impact on HIV and gonorrhea rates. JAMA, 1992;268:3338–3343.

    Article  PubMed  CAS  Google Scholar 

  17. UNAIDS. Report on the Global HIV/AIDS epidemic, June 2000. Geneva, Switzerland: UNAIDS, 2000.

    Google Scholar 

  18. Celentano DD, Nelson KE, Lyles CM, et al. Decreasing incidence of HIV and sexually transmitted diseases in young Thai men: evidence for success of the HIV/AIDS control and prevention program. AIDS, 1998;12:F29–F36.

    Article  PubMed  CAS  Google Scholar 

  19. Rojanapithayakorn W, Hanenberg R. The 100% condom program in Thailand. AIDS, 1996;10:1–7.

    PubMed  CAS  Google Scholar 

  20. Lawson L, Katzenstein D, Vermund S. Emerging biomedical interventions. In: Gibney L, DiClemente J, Vermund SH, eds. Preventing HIV in. Developing Countries: Biomedical and Behavioral. Approaches. New York: Kluwer Academic/Plenum, 1999:43–69.

    Google Scholar 

  21. Moses S, Plummer FA, Ngugi EN, et al. Controlling HIV in Africa: effectiveness and cost of an intervention in a high-frequency STD transmitter core group. AIDS, 1991;5:407–411.

    PubMed  CAS  Google Scholar 

  22. Meda N, Ndoye I, M’Boup S, et al. Low and stable HIV infection rates in Senegal: natural course of the epidemic or evidence for success of prevention? AIDS, 1999;13:1397–1405.

    PubMed  CAS  Google Scholar 

  23. Leonard L, Ndiaye I, Kapadia A, et al. HIV prevention among male clients of female sex workers in Kaolack, Senegal: results of a peer education program. AIDS Educ Prev, 2000; 12:21–37.

    PubMed  CAS  Google Scholar 

  24. Moema S, Neilsen G, Mzaidume Y, et al. Into the pocket, onto the penis: condom distribution in Carletonville, South Africa. In: Abstracts of the XIII International Conference on AIDS; July 9–14, 2000; Durban, South Africa. Abstract MoOrC249.

    Google Scholar 

  25. Stoneburner R. Analysis of HIV trend and behavioral data in Uganda, Kenya, and Zambia: prevalence declines in Uganda relate more to reduction in sex partners than condom use. In: Abstracts of the XIII International Conference on AIDS; July 9–14, 2000; Durban, South Africa. Abstract ThOrC721.

    Google Scholar 

  26. Nakityo R, Mugyenyi D. The role of the media in HIV prevention in Uganda. In: Abstracts of the XIII International Conference on AIDS; July 9–14, 2000; Durban, South Africa. Abstract TuPeE3872.

    Google Scholar 

  27. Whitworth J, Muyinda H, Pool R. Harnessing traditional sex education institutions: the senga model in Uganda. In: Abstracts of the XIII International Conference on AIDS; July 9–14, 2000; Durban, South Africa. Abstract WePeD4704.

    Google Scholar 

  28. Goodridge GA, Lamptey PR. HIV prevention for the general population. In: Gibney L, DiClemente J, Vermund SH, eds. Preventing HIV in Developing. Countries: Biomedical and Behavioral Approaches. New York: Kluwer Academic/Plenum, 1999:331–362.

    Google Scholar 

  29. Marck J. Aspects of male circumcision in subequatorial African culture history. Health Transit. Rev, 1997;7(Suppl):337–360.

    PubMed  Google Scholar 

  30. Schapera I. Tribal Innovators. London: The Athlone Press; 1970.

    Google Scholar 

  31. Moses S, Bradley JE, Nagelkerke NJ, et al. Geographical patterns of male circumcision practices in Africa: association with HIV seroprevalence. Int J Epidemiol, 1990;19:693–697.

    PubMed  CAS  Google Scholar 

  32. Halperin DT, Bailey RC. Male circumcision and HIV infection: 10 years and counting. Lancet, 1999;35:1813–1815.

    Google Scholar 

  33. Moses S, Plummer FA, Bradley JE, et al. The association between lack of male circumcision and risk for HIV infection: a review of the epidemiological data. Sex Transm Dis, 1994;21:201–210.

    PubMed  CAS  Google Scholar 

  34. Moses S, Bailey RC, Ronald AR. Male circumcision: assessment of health benefits and risks. Sex. Transm Inf, 1998;74:368–373.

    CAS  Google Scholar 

  35. Weiss HA, Quigley MA, Hayes RJ. Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. AIDS,2000;14:2361–2370.

    PubMed  CAS  Google Scholar 

  36. Cameron BE, Simonsen JN, D’Costa LJ, et al. Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Lancet, 1989;2:403–407.

    PubMed  CAS  Google Scholar 

  37. Tyndall MW, Ronald AR, Agoki E, et al. Increased risk of infection with human immunodeficiency virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis, 1996;23:449–453.

    PubMed  CAS  Google Scholar 

  38. Telzak ET, Chiasson MA, Bevier PJ, et al. HIV-1 seroconversion in patients with and without genital ulcer disease: a prospective study. Ann Intern Med, 1993;119:1181–1186.

    PubMed  CAS  Google Scholar 

  39. Mehendale SM, Shepherd ME, Divekar AD, et al. Evidence for high prevalence and rapid transmission of HIV among individuals attending STD clinics in Pune, India. Indian J Med Res, 1996; 104:327–335.

    PubMed  CAS  Google Scholar 

  40. Kassler WJ, Aral SO. Beyond risk groups: behavioral correlates of HIV seroconversion in sexually transmitted disease clinic patients. In: Abstract monograph, XI International Meeting of the International Society for STD Research; 27–30 Aug 1995; New Orleans, USA. Abstract 107.

    Google Scholar 

  41. Kapiga SH, Lyamuya EF, Lwihula GK, et al. The incidence of HIV infection among women using family planning methods in Dar Es Salaam, Tanzania. AIDS, 1998; 12:75–84.

    Article  PubMed  CAS  Google Scholar 

  42. Lavreys L, Rakwar JP, Thompson ML, et al. Effect of circumcision on incidence of human immunodeficiency virus type 1 and other sexually transmitted diseases: a prospective cohort study of trucking company employees in Kenya. J Infect Dis, 1999;180:330–336.

    Article  PubMed  CAS  Google Scholar 

  43. Kelly R, Kiwanuka N, Wawer MJ, et al. Age of male circumcision and risk of prevalent HIV infection in rural Uganda. AIDS, 1999;13:399–405.

    PubMed  CAS  Google Scholar 

  44. Gray RH, Kiwanuka N, Quinn TC, et al. Male circumcision and HIV acquisition and transmission: cohort studies in Rakai, Uganda. AIDS, 2000; 14:2371–2381.

    PubMed  CAS  Google Scholar 

  45. Quigley M, Munguti K, Grosskurth H, et al. Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study. AIDS, 1997; 11:237–248.

    Article  PubMed  CAS  Google Scholar 

  46. Bailey RC, Neema S, Othieno R. Sexual behaviors and other HIV risk factors in circumcised and uncircumcised men in Uganda. J Acquir Immune. Defic Syndr, 1999;22:294–301.

    PubMed  CAS  Google Scholar 

  47. Soto-Ramirez LE, Renjifo B, McLane MF, et al. HIV-1 Langerhans’ Cell Tropism Associated with Heterosexual Transmission of HIV. Science, 1996;271:1291–1293.

    PubMed  CAS  Google Scholar 

  48. Szabo R, Short RV How does male circumcision protect against HIV infection? BMJ, 2000;320:1592–1594.

    Article  PubMed  CAS  Google Scholar 

  49. Cook LS, Koutsky LA, Holmes KK. Circumcision and sexually transmitted diseases. Am J Public. Health, 1994;84:197–201.

    PubMed  CAS  Google Scholar 

  50. Flemming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex. Transm Infect, 1999;75:3–17.

    Article  Google Scholar 

  51. Orroth KK, Gavyole A, Todd J, et al. Syndromic treatment of sexually transmitted diseases reduces the proportion of incident HIV infections attributable to these diseases in rural Tanzania. AIDS, 2000;14:1429–1437.

    PubMed  CAS  Google Scholar 

  52. Schoen EJ, Wiswell TE, Moses S. New Policy on Circumcision-Cause for Concern. Pediatrics, 2000;105:620–623.

    PubMed  CAS  Google Scholar 

  53. Wiswell TE, Hachey WE. Urinary tract infections and the circumcision state: an update. Clin Pediat, 1993;32:130–134.

    Article  PubMed  CAS  Google Scholar 

  54. American Academy of Pediatrics. Report of the task force on circumcision. Pediatrics, 1989;84:388–391.

    Google Scholar 

  55. Kochen M, McCurdy S. Circumcision and risk of cancer of the penis. A life-table analysis. Am J Dis. Child, 1980;134:484–486.

    PubMed  CAS  Google Scholar 

  56. Wiswell TE. Circumcision circumspection. N Engl. J Med, 1997;336:1244–1245.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA

    Roger L. Shapiro

  2. Department of Population and International Health, Harvard School of Public Health, Boston, Massachusetts, USA

    Saidi H. Kapiga

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  1. Roger L. Shapiro
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Editors and Affiliations

  1. Harvard AIDS Institute Mary Woodard Lasker Professor of Health Sciences Harvard University, Boston, Massachusetts, USA

    Max Essex DVM, PhD (Chairman) & Richard G. Marlink MD (Senior Research and Executive Director) (Chairman) &  (Senior Research and Executive Director)

  2. Laboratory of Bacteriology and Virology CHU Le Dantec, Université Cheikh Anta Diop, Dakar, Senegal

    Souleymane Mboup PharmD, PhD (Professor of Microbiology) (Professor of Microbiology)

  3. Department of Immunology and Infectious Diseases and the Harvard AIDS Institute, Harvard School of Public Health, Boston, Massachusetts, USA

    Phyllis J. Kanki DVM, DSc (Professor of Immunology and Infectious Diseases) & Molly Holme (Professor of Immunology and Infectious Diseases) & 

  4. Department of Nursing Education University of Botswana, Gaborone, Botswana

    Sheila D. Tlou PhD (Associate Professor) (Associate Professor)

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© 2002 Kluwer Academic Publishers

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Shapiro, R.L., Kapiga, S.H. (2002). Male Condoms and Circumcision. In: Essex, M., Mboup, S., Kanki, P.J., Marlink, R.G., Tlou, S.D., Holme, M. (eds) AIDS in Africa. Springer, Boston, MA. https://doi.org/10.1007/0-306-47817-X_31

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  • DOI: https://doi.org/10.1007/0-306-47817-X_31

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-46699-1

  • Online ISBN: 978-0-306-47817-8

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