Table 1.
Factors Associated With Detectable Penile HSV-2 Shedding Through 6 Weeks After MC Among 176 HIV-Infected Men in Rakai, Ugandaa
| Factor | Post-MC Visits With HSV Shedding/ Total Post-MC Visits, No. (%) | PRR (95% CI) | P Value | aPRR (95% CI) | P Value |
|---|---|---|---|---|---|
| Overall | 80/781 (10.2) | … | … | … | … |
| Age, y | |||||
| 15–29 | 29/238 (12.2) | 1.00 (Ref) | … | 1.00 (Ref) | … |
| 30–39 | 34/378 (10.3) | 0.73 (.39–1.35) | .31 | 0.76 (.42–1.40) | .38 |
| ≥40 | 17/165 (9.0) | 0.84 (.39–1.85) | .67 | 0.90 (.40–2.40) | .80 |
| Genital ulcer disease within 30 d before MC | |||||
| No | 63/671 (9.4) | 1.00 (Ref) | … | 1.00 (Ref) | … |
| Yes | 17/110 (15.5) | 1.60 (.88–2.94) | .13 | 1.57 (.89–2.74) | .13 |
| Certified healed wound | |||||
| No | 57/475 (12.0) | 1.00 (Ref) | … | 1.00 (Ref) | … |
| Yes | 22/288 (7.6) | 0.61 (.36–1.06) | .08 | 0.62 (.35–1.08) | .09 |
| Resumed sexb | |||||
| No | 65/627 (10.4) | 1.00 (Ref) | … | … | … |
| Yes | 15/136 (11.0) | 0.91 (.51–1.63) | .76 | … | … |
| Presurgical penile HSV-2 shedding | |||||
| No | 68/707 (9.6) | 1.00 (Ref) | … | 1.00 (Ref) | … |
| Yes | 12/74 (16.2) | 1.75 (.86–3.62) | .12 | 1.77 (.95–3.32) | .07 |
| Postsurgical penile HIV shedding | |||||
| No | 69/674 (10.2) | 1.00 (Ref) | … | 1.00 (Ref) | … |
| Yes | 11/104 (10.6) | 1.07 (.61–1.88) | .82 | 0.89 (.49–1.60) | .82 |
| Presurgical CD4+ T-cell count, cells/µL | |||||
| >600 | 28/300 (9.3) | 1.00 (Ref) | … | … | … |
| 200–500 | 43/378 (11.4) | 1.19 (.64–2.18) | .58 | 1.20 (.63–2.27) | .58 |
| <200 | 9/103 (8.7) | 0.92 (.41–2.05) | .84 | 0.96 (.41–2.22) | .84 |
| Plasma HIV load, copies/mLb | |||||
| <400 (undetectable) | 16/175 (9.1) | 1.00 (Ref) | … | … | … |
| 400–9999 | 22/144 (15.3) | 1.35 (.63–2.90) | .44 | … | … |
| 10 000–49 999 | 10/168 (6.0) | 0.63 (.24–1.63) | .34 | … | … |
| >50 000 | 31/259 (12.0) | 1.25 (.61–2.57) | .55 | … | … |
| Self-reported ART and plasma HIV load | |||||
| ART naive | 70/643 (10.9) | 1.00 (Ref) | … | 1.00 (Ref) | … |
| ART but detectable HIV load | 4/41 (9.8) | 0.87 (.31–2.45) | .80 | 1.04 (.38–2.79) | .94 |
| ART and suppressed HIV load | 6/97 (6.2) | 0.57 (.21–1.54) | .27 | 0.64 (.22–1.87) | .41 |
Abbreviations: aPRR, adjusted prevalence risk ratio; ART, antiretroviral therapy; CI, confidence interval; HIV, human immunodeficiency virus; HSV-2, herpes simplex virus type 2; MC, male circumcision; PRR, prevalence risk ratio; Ref, reference standard.
a Wound healing, resumption of sex, plasma HIV load, and postsurgical penile HIV shedding were assessed as time-varying factors at the same visit as penile HSV-2 shedding. All other factors were measured at the presurgical visit.
b Resumption of sex and plasma HIV load were not included in the adjusted model because of collinearity (ie, high correlation) with wound healing and ART/plasma HIV load status variables, respectively.