Male Genital Hygiene Affects Risk of HIV Infection
October 13, 2006
Two new reports suggest regularly washing the penis lowers the risk of HIV infection in both circumcised and uncircumcised men.
Male circumcision is associated with reduced HIV prevalence, Dr. Nigel O'Farrell of Ealing Hospital in London and colleagues noted in their study. They theorized that "subpreputial penile wetness" -- a lanolin-like wetness found under the foreskin in most uncircumcised men -- would increase HIV risk, thus regular washing to keep this area dry could reduce risk.
The researchers studied 386 uncircumcised men living in or near Durban, South Africa, who did not have genital lesions or discharge. Examinations of the men showed half had some degree of wetness around the penis, of whom 80 percent were judged to be slightly wet, 19 percent as wet, and 2 percent as very wet. Just one of 36 circumcised men the researchers examined had wetness.
HIV prevalence was 66.3 percent among men with penile wetness, compared to 45.9 percent in those without wetness. After adjusting for HIV predictors and confounders, the adjusted odds ratio for HIV infection was 2.27 when comparing men with wetness versus men without. HIV risk was not affected by the degree of wetness.
HIV prevalence among uncircumcised men without wetness was similar to that of circumcised men (42.9 percent), O'Farrell and colleagues found. Despite the fact that numerous factors associated with penile wetness were related to poverty, the researchers suggested that "information, education, and communication programs at a number of levels would be needed: for instance, encouraging washing related to sexual activity -- precoital or postcoital or as an everyday life skill."
In the second study, scientists from Seattle's Harborview Medical Center interviewed 150 men in Kenya about their socioeconomic status and hygiene practices. Of the sample, 15 percent of the men were HIV-positive, and 97 percent were circumcised.
Dr. King K. Holmes and colleagues found that aspects of hygiene associated with risk included the amount of time spent in a bath (more than 10 minutes) and bathing immediately after sex. After conducting multivariate analysis, the scientists found that previous treatment for a serious illness, circumcision and genital hygiene were independent risk factors for HIV infection.
The reports, "Association Between HIV and Subpreputial Penile Wetness in Uncircumcised Men in South Africa" and "Independent Association of Hygiene, Socioeconomic Status, and Circumcision with Reduced Risk of HIV Infection Among Kenyan Men," were published in the Journal of Acquired Immune Deficiency Syndromes (2006;43(1):69-77 and 117-118, respectively).