The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania

Kapiga, Saidi; Lyamuya, Eligius; Lwihula, George K.; Hunter, David J.

doi:10.1097/00002030-199801000-00009

Cited by 174 publications

(119 citation statements)

References 29 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…The first study describes a protective effect but had considerable loss-to-follow-up and possible misclassification of the partners' circumcision status. 63 The other study showed nonsignificant protection in the high-risk group (ie, women who were more likely to have ever engaged in sex work; to have reported 2 or more partners in the last 3 months; and/or to have had a higher median lifetime number of sex partners) but neither protection nor increased risk in the study population as a whole. 64 A metaanalysis with good evidence of data from 1 randomized controlled trial (RCT) and 6 longitudinal analyses found little evidence that male circumcision directly reduces their female partner' s risk of acquiring HIV (summary relative risk: 0.8 [95% confidence interval (CI): 0.53-1.36]); however, male circumcision' s protective effect did not reach a level of statistical significance.…”

Section: Heterosexual Womenmentioning

confidence: 84%

Male Circumcision

Blank¹,

Brady²,

Buerk³

et al. 2012

Pediatrics

295

149

View full text Add to dashboard Cite

Male circumcision consists of the surgical removal of some, or all, of the foreskin (or prepuce) from the penis. It is one of the most common procedures in the world. In the United States, the procedure is commonly performed during the newborn period. In 2007, the American Academy of Pediatrics (AAP) convened a multidisciplinary workgroup of AAP members and other stakeholders to evaluate the evidence regarding male circumcision and update the AAP’s 1999 recommendations in this area. The Task Force included AAP representatives from specialty areas as well as members of the AAP Board of Directors and liaisons representing the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention. The Task Force members identified selected topics relevant to male circumcision and conducted a critical review of peer-reviewed literature by using the American Heart Association’s template for evidence evaluation. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks; furthermore, the benefits of newborn male circumcision justify access to this procedure for families who choose it. Specific benefits from male circumcision were identified for the prevention of urinary tract infections, acquisition of HIV, transmission of some sexually transmitted infections, and penile cancer. Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction. It is imperative that those providing circumcision are adequately trained and that both sterile techniques and effective pain management are used. Significant acute complications are rare. In general, untrained providers who perform circumcisions have more complications than well-trained providers who perform the procedure, regardless of whether the former are physicians, nurses, or traditional religious providers. Parents are entitled to factually correct, nonbiased information about circumcision and should receive this information from clinicians before conception or early in pregnancy, which is when parents typically make circumcision decisions. Parents should determine what is in the best interest of their child. Physicians who counsel families about this decision should provide assistance by explaining the potential benefits and risks and ensuring that parents understand that circumcision is an elective procedure. The Task Force strongly recommends the creation, revision, and enhancement of educational materials to assist parents of male infants with the care of circumcised and uncircumcised penises. The Task Force also strongly recommends the development of educational materials for providers to enhance practitioners’ competency in discussing circumcision’s benefits and risks with parents. The Task Force made the following recommendations:Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and the benefits of newborn male circumcision justify access to this procedure for those families who choose it.Parents are entitled to factually correct, nonbiased information about circumcision that should be provided before conception and early in pregnancy, when parents are most likely to be weighing the option of circumcision of a male child.Physicians counseling families about elective male circumcision should assist parents by explaining, in a nonbiased manner, the potential benefits and risks and by ensuring that they understand the elective nature of the procedure.Parents should weigh the health benefits and risks in light of their own religious, cultural, and personal preferences, as the medical benefits alone may not outweigh these other considerations for individual families.Parents of newborn boys should be instructed in the care of the penis, regardless of whether the newborn has been circumcised or not.Elective circumcision should be performed only if the infant’s condition is stable and healthy.Male circumcision should be performed by trained and competent practitioners, by using sterile techniques and effective pain management.Analgesia is safe and effective in reducing the procedural pain associated with newborn circumcision; thus, adequate analgesia should be provided whenever newborn circumcision is performed.Nonpharmacologic techniques (eg, positioning, sucrose pacifiers) alone are insufficient to prevent procedural and postprocedural pain and are not recommended as the sole method of analgesia. They should be used only as analgesic adjuncts to improve infant comfort during circumcision.If used, topical creams may cause a higher incidence of skin irritation in low birth weight infants, compared with infants of normal weight; penile nerve block techniques should therefore be chosen for this group of newborns.Key professional organizations (AAP, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American Society of Anesthesiologists, the American College of Nurse Midwives, and other midlevel clinicians such as nurse practitioners) should work collaboratively to:Develop standards of trainee proficiency in the performance of anesthetic and procedure techniques, including suturing;Teach the procedure and analgesic techniques during postgraduate training programs;Develop educational materials for clinicians to enhance their own competency in discussing the benefits and risks of circumcision with parents;Offer educational materials to assist parents of male infants with the care of both circumcised and uncircumcised penises.The preventive and public health benefits associated with newborn male circumcision warrant third-party reimbursement of the procedure. The American College of Obstetricians and Gynecologists has endorsed this technical report.

show abstract

Section: Heterosexual Womenmentioning

confidence: 84%

Male Circumcision

Blank¹,

Brady²,

Buerk³

et al. 2012

Pediatrics

295

149

View full text Add to dashboard Cite

show abstract

“…Of the 20 studies included in Fisher and colleagues' meta-analysis, 19 were retained for inclusion in the present study (Ao, Sam, Masenga, Seage, & Kapiga, 2006;Ayisi et al, 2000;Braddick et al, 1990;Demissie, Amre, & Tsega, 1996;Fritz et al, 2002;Hargreaves et al, 2002;Kapiga, Lyamuya, Lwihula, & Hunter, 1998;Kapiga et al, 2002;Kapiga et al, 2006;Lewis et al, 2005;Mbulaiteye et al, 2000;Mnyika, Klepp, Kvåle, & Ole-King'ori, 1996;Ndina-Achola et al, 1997;Sebit et al, 2003;Simbayi et al, 2004;Talbot et al, 2002;Tengia-Kessey, Msamanga, & Moshino, 1998;Zablotska et al, 2006;Zuma, Gouws, Williams, & Lurie, 2003) and one (Gilgen, Williams, & Campbell, 2000) was excluded for failing to meet the inclusion criteria specified below (i.e., it was not published in a peer-reviewed journal). An additional eight nonoverlapping studies published prior to 2009 were identified from our previous narrative review (Allen et al, 1992;Bassett et al, 1996;Clift et al, 2003;Dunkle et al, 2004;Fisher, Cook, Sam, & Kapiga, 2008;Msuya et al, 2006;St.…”

Section: Methods Literature Reviewmentioning

confidence: 99%

An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

Woolf‐King

Steinmaus

Reingold

et al. 2013

IJADR

View full text Add to dashboard Cite

Aims: Sub-Saharan Africa is disproportionately affected by HIV/AIDS, and growing evidence suggests that alcohol consumption is a co-occurring problem in the region. We conducted a meta-analysis on studies of alcohol use and HIV infection in subSaharan Africa in order to assess associations, evaluate heterogeneity in the literature, identify susceptible subgroups, and suggest avenues for future research.Design: We performed a systematic review, including published review articles and electronic database searches, and identified 35 studies on alcohol use and HIV. Setting and participants:All of the studies included in the meta-analysis occurred with adults in sub-Saharan Africa.Measurements: Pooled odds ratio (OR) estimates were calculated using both the fixed inverse variance weighting method and the random effects method when evidence of heterogeneity was present. Findings:The pooled OR estimate for all studies was 1.61 (95% CI: 1.44-1.80). The association between alcohol use and prevalence or incident HIV infection was particularly large among samples who reported problem drinking (OR = 2.17, 95% CI: 1.64-2.87) and drinking in sexual contexts (OR = 1.79, 95% CI: 1.55-2.06). Some evidence of publication bias was present; however, the OR remained statistically significant in small and large studies and with population-based and high-risk samples.

show abstract

“…a period of 1 to 3 years). Even though condom use was comparable between alcohol drinkers and non-drinkers, sero-conversion risk was found to be higher for those who consumed alcohol (Kapiga et al, 1998). In a Tanzanian sample of men, Ghebremichael and Paintsil (2009) found condom use with a main partner to be low after alcohol consumption in a sample of 789 men, even though 6.5% of the subjects were identified to be HIV-positive.…”

Section: Heterosexual Couples Outside Of the United Statesmentioning

confidence: 86%

“…In a sample of 1370 women in Tanzania, Kapiga et al (1998) observed that 5.5% of their s a m p l e ( 3 . 8 % o f n o n -d r i n k e r s a n d 9 .…”

Section: Heterosexual Couples Outside Of the United Statesmentioning

confidence: 99%

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

Neuman¹,

Schneider²,

Nanau³

et al. 2012

Public Health - Social and Behavioral Health

View full text Add to dashboard Cite

The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania

Abstract: These findings confirm that a large number of new HIV infections continue to occur in this population. Reassuringly, no significant association was observed between HIV and use of specific contraceptive methods. Interventions to reduce further spread of HIV are still urgently needed.

Cited by 174 publications

References 29 publications

Male Circumcision

Male Circumcision

An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

Contact Info

Product

Resources

About