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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial
PLoS Medicine, Volume 2, No. 11, Article e298, Year 2005
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Description
Background: Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis. Methods and Findings: A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR) of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 - RR. The trial was stopped at the interim analysis, and the mean (interquartile range) follow-up was 18.1 mo (13.0-21.0) when the data were analyzed. There were 20 HIV infections (incidence rate=0.85 per 100 person-years) in the intervention group and 49 (2.1 per 100 person-years) in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001). This RR corresponds to a protection of 60% (95% CI: 32%-76%). When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%). Conclusion: Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil.) © 2005 Auvert et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC1262556/bin/pmed.0020298.st001.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC1262556/bin/pmed.0020298.st002.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC1262556/bin/pmed.0020298.st003.pdf
Authors & Co-Authors
Auvert, Bertran
France, Boulogne-billancourt
Hopital Ambroise Pare, Boulogne-billancourt
France, Paris
Inserm
France, Versailles
Université de Versailles Saint-quentin-en-yvelines
France, Villejuif
Ifr69
Taljaard, Dirk J.
South Africa, Johannesburg
Progressus
Lagarde, Emmanuel
France, Paris
Inserm
France, Villejuif
Ifr69
Sobngwi-Tambekou, Jöelle Laure
France, Paris
Inserm
Sitta, Rémi
France, Paris
Inserm
France, Villejuif
Ifr69
Puren, Adrian
South Africa, Johannesburg
National Institute for Communicable Disease
Statistics
Citations: 2,630
Authors: 6
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pmed.0020298
ISSN:
15491277
e-ISSN:
15491676
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
South Africa
Participants Gender
Male