Trial reportLancet (London, England)2009
Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trial.
Trial report in Lancet (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00124878 (Trial of Male Circumcision), which is not on this map. Cited by 129 papers, 12 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.
Trial of Male Circumcision: HIV, STD and Behavioral Effects in Men, Women and the Community
Who cites it
129 citing papers in PubMed, 12 syntheses or guidelines pooled it, 304 citations in OpenAlex.
- Complex solutions for a complex problem: A meta-analysis of the efficacy of multiple-behavior interventions on change in outcomes related to HIV.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2021Pooled it
- Critical evaluation of arguments opposing male circumcision: A systematic review.Journal of evidence-based medicine · 2019Pooled it
- Association of Male Circumcision with Women's Knowledge of its Biomedical Effects and With Their Sexual Satisfaction and Function: A Systematic Review.AIDS and behavior · 2019Pooled it
- Association between male circumcision and women's biomedical health outcomes: a systematic review.The Lancet. Global health · 2017Pooled it
- Circumcision Status and Risk of HIV Acquisition during Heterosexual Intercourse for Both Males and Females: A Meta-Analysis.PloS one · 2015Pooled it
- Systematic review of couple-based HIV intervention and prevention studies: advantages, gaps, and future directions.AIDS and behavior · 2014Pooled it
- Preconception care: preventing and treating infections.Reproductive health · 2014Pooled it
- Heterosexual HIV-1 infectiousness and antiretroviral use: systematic review of prospective studies of discordant couples.Epidemiology (Cambridge, Mass.) · 2013Pooled it
- A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.PloS one · 2012Pooled it
- Will circumcision provide even more protection from HIV to women and men? New estimates of the population impact of circumcision interventions.Sexually transmitted infections · 2011Pooled it
- Weighing the gold in the gold standard: challenges in HIV prevention research.AIDS (London, England) · 2010Pooled it
- Guideline
- HIV shedding from male circumcision wounds in HIV-infected men: a prospective cohort study.PLoS medicine · 2015Trial
- Association between male circumcision and incidence of syphilis in men and women: a prospective study in HIV-1 serodiscordant heterosexual African couples.The Lancet. Global health · 2014Trial
- Effect of text messaging to deter early resumption of sexual activity after male circumcision for HIV prevention: a randomized controlled trial.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- Trial
- Trial
- Predicting product adherence in a topical microbicide safety trial in Pune, India.AIDS and behavior · 2012Trial
- Factors associated with the early resumption of sexual activity following medical male circumcision in Nyanza province, Kenya.AIDS and behavior · 2012Trial
- 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
69 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundObservational studies have reported an association between male circumcision and reduced risk of HIV infection in female partners. We assessed whether circumcision in HIV-infected men would reduce transmission of the virus to female sexual partners.
methods922 uncircumcised, HIV-infected, asymptomatic men aged 15-49 years with CD4-cell counts 350 cells per microL or more were enrolled in this unblinded, randomised controlled trial in Rakai District, Uganda. Men were randomly assigned by computer-generated randomisation sequence to receive immediate circumcision (intervention; n=474) or circumcision delayed for 24 months (control; n=448). HIV-uninfected female partners of the randomised men were concurrently enrolled (intervention, n=93; control, n=70) and followed up at 6, 12, and 24 months, to assess HIV acquisition by male treatment assignment (primary outcome). A modified intention-to-treat (ITT) analysis, which included all concurrently enrolled couples in which the female partner had at least one follow-up visit over 24 months, assessed female HIV acquisition by use of survival analysis and Cox proportional hazards modelling. This trial is registered with ClinicalTrials.gov, number NCT00124878.
findingsThe trial was stopped early because of futility. 92 couples in the intervention group and 67 couples in the control group were included in the modified ITT analysis. 17 (18%) women in the intervention group and eight (12%) women in the control group acquired HIV during follow-up (p=0.36). Cumulative probabilities of female HIV infection at 24 months were 21.7% (95% CI 12.7-33.4) in the intervention group and 13.4% (6.7-25.8) in the control group (adjusted hazard ratio 1.49, 95% CI 0.62-3.57; p=0.368).
interpretationCircumcision of HIV-infected men did not reduce HIV transmission to female partners over 24 months; longer-term effects could not be assessed. Condom use after male circumcision is essential for HIV prevention.
fundingBill & Melinda Gates Foundation with additional laboratory and training support from the National Institutes of Health and the Fogarty International Center.
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What OpenQuestion holds
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.