Trial reportAIDS (London, England)2009
Incident HIV and herpes simplex virus type 2 infection among men in Rakai, Uganda.
Trial report in AIDS (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Pooled it
- Critical evaluation of arguments opposing male circumcision: A systematic review.Journal of evidence-based medicine · 2019Pooled it
- Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis.The Lancet. Infectious diseases · 2017Pooled it
- Guideline
- Chemokine Levels in the Penile Coronal Sulcus Correlate with HIV-1 Acquisition and Are Reduced by Male Circumcision in Rakai, Uganda.PLoS pathogens · 2016Trial
- Reactivation of herpes simplex virus type 2 after initiation of antiretroviral therapy.The Journal of infectious diseases · 2013Trial
- Male circumcision and herpes simplex virus type 2 infection in female partners: a randomized trial in Rakai, Uganda.The Journal of infectious diseases · 2012Trial
- Male circumcision and anatomic sites of penile high-risk human papillomavirus in Rakai, Uganda.International journal of cancer · 2011Trial
- Circumcision of HIV-infected men and transmission of human papillomavirus to female partners: analyses of data from a randomised trial in Rakai, Uganda.The Lancet. Infectious diseases · 2011Trial
- Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: a randomised trial in Rakai, Uganda.Lancet (London, England) · 2011Trial
- Aetiology of genital ulcer disease in female partners of male participants in a circumcision trial in Uganda.International journal of STD & AIDS · 2009Trial
- Does the evidence support circumcision of infant males in the United Kingdom?-a systematic review.Translational andrology and urology · 2026Review
- Individual and population-level risk factors for new HIV infections among adults in Eastern and Southern Africa.Nature communications · 2026Article
- Neonatal Male Circumcision: Clearly Beneficial for Public Health or an Ethical Dilemma? A Systematic Review.Cureus · 2024Review
- Comments by opponents on the British Medical Association's guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health.World journal of clinical pediatrics · 2023Article
- Infant Circumcision for Sexually Transmitted Infection Risk Reduction Globally.Global health, science and practice · 2022Article
- Evidence-based circumcision policy for Australia.Journal of men's health · 2022Article
- Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (full version).Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2018Article
- Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy.World journal of clinical pediatrics · 2017Article
- Prevalence, incidence and correlates of HSV-2 infection in an HIV incidence adolescent and adult cohort study in western Kenya.PloS one · 2017Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveHerpes simplex virus type 2 (HSV-2) infection is associated with an increased risk for acquiring HIV, but little is known about the temporal sequence of these infections.
design: Six thousand three hundred ninety-six men were evaluated for serologic HSV-2 and HIV infections and behaviors during a male circumcision trial in Rakai, Uganda.
methodsHIV and HSV-2 status were determined using enzyme-linked immunosorbent assays and confirmed by HIV-1 and HSV-2 western blots. A Poisson multivariable model was used to estimate adjusted incidence rate ratios of HIV acquisition associated with HSV-2 and other covariates.
resultsHIV incidence was 1.09/100 person-years and acquisition was associated with incident HSV-2 infection [adjusted incidence rate ratio (adjIRR) 5.28, 95% confidence interval (CI) 2.79-9.98], chronic HSV-2 infection (adjIRR 2.78, 95% CI 1.64-5.68), genital ulcer disease, urethral discharge, genital washing after intercourse, being unmarried, and being uncircumcised. Sixteen men acquired both HIV and HSV-2 during the trial: four acquired HIV first, three acquired HSV-2 first, and nine acquired both infections in the same follow-up interval.
conclusionThe findings suggest that unsafe sex places men at risk of both HIV and HSV-2 infections, and it is unclear whether HSV-2 acquisition is a cofactor for HIV infection or a marker of correlated sexual exposures. This reinforces the need for promotion of safe sex as the primary method of prevention of both viruses.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.