Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial
Baseline characteristics of the men in the intervention and control groups were much the same at enrolment. Retention rates were much the same in the two groups, with 90–92% of participants retained at all time points. In the modified intention-to-treat analysis, HIV incidence over 24 months was 0·66 cases per 100 person-years in the intervention group and 1·33 cases per 100 person-years in the control group (estimated efficacy of intervention 51%, 95% CI 16–72; p=0·006). The as-treated efficacy was 55% (95% CI 22–75; p=0·002); efficacy from the Kaplan-Meier time-to-HIV-detection as-treated analysis was 60% (30–77; p=0·003). HIV incidence was lower in the intervention group than it was in the control group in all sociodemographic, behavioural, and sexually transmitted disease symptom subgroups. Moderate or severe adverse events occurred in 84 (3·6%) circumcisions; all resolved with treatment. Behaviours were much the same in both groups during follow-up.
A randomized controlled trial of male circumcision to reduce HIV incidence in Kisumu, Kenya;
Methods: Sexually active 18-24 year-old men are counselled and tested for HIV. Seronegative consenting men are randomized equally to treatment (circumcision) and control (non-circumcision)arms. The circumcised men are examined 3 and 8 days after surgery. Men in both arms are counseled and tested for HIV at 1 and 3 months after enrollment and are followed at 6, 12, 18 and 24 months with additional HIV testing, STI testing and treatment, and behavioral risk assessment. Men who are positive at screening or seroconvert are referred to a post-test support group offering care and treatment. The sample size of 2784 is designed to detect a 50% reduction in HIV incidence.
Results: Of 6686 men screened, 2784 (42%) were randomized, 1391 to MC, of whom 1334 (95.9%) completed the procedure. 11 (0.8%) of controls were circumcised off protocol. As of January 15, 2006, 744 men (86% of expected number) had completed 24 months of follow-up. Total follow-up was 3146 person-years (PY), and 54 HIV seroconversions had occurred. There were 24 adverse events among 23 men (1.7%) considered related to the MC procedure, mainly post-operative bleeding or infection, none severe, and they resolved quickly without sequellae. Incidences of gonorrhea and chlamydia infection were 4.5 and 4.7 per 100 PYs, respectively.
Related;
Male Circumcision: Is It Time to Act?
Rwanda: Government Readies for Mass Male Circumcision
Uncircumcised? Washing After Sex Might Be Risky
NIAID-Sponsored Adult Male Circumcision Trials in Kenya and Uganda
2 comments:
^^ Behaviours were much the same in both groups during follow-up. ^^
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I can't be the only one to whom the obvious lie of that jumps out.
In what way is a cut man's behavior (abstinent for 6-8 weeks during recovery) like an intact man's?
It can take months for an HIV infection to be measurable, so these researchers exagerated this confounder by cutting the study short.
I wouldn't argue that removing half the penile surface could cut the chance for invading cooties to get through, but condoms are far more effective than surgery. Most of the US men who have died of AIDS were circumcised at birth.
The studies relate to female to male heterosexual HIV transmission. The majority of US men who died of AIDS were infected through anal sex.To try to force a connection is intellectually dishonest.
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