Trial reportAIDS (London, England)2009
Foreskin surface area and HIV acquisition in Rakai, Uganda (size matters).
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. It is linked to trial NCT03412071 (Testing the Ability of a Microbiome - Focused Intervention to Reduce HIV Susceptibility in Ugandan Men), which is not on this map. Cited by 52 papers, 1 of them a synthesis 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.
Testing the Ability of a Microbiome - Focused Intervention to Reduce HIV Susceptibility in Ugandan Men
Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it, 107 citations in OpenAlex.
- Critical evaluation of arguments opposing male circumcision: A systematic review.Journal of evidence-based medicine · 2019Pooled it
- Circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for the treatment for chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, multicenter trial.World journal of urology · 2015Trial
- HIV Transmission and Immunology of the Male Reproductive Tract.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Does the evidence support circumcision of infant males in the United Kingdom?-a systematic review.Translational andrology and urology · 2026Review
- Calculating foreskin surface area based on glans measurements of 143 men using a simplified geometrical model of the foreskin.International journal of impotence research · 2026Article
- HIV-associated penile anaerobes disrupt epithelial barrier integrity.PLoS pathogens · 2025Article
- Decellularization techniques of human foreskin for tissue engineering application.Physiological research · 2023Article
- Psychological, psychosocial, and psychosexual aspects of penile circumcision.International journal of impotence research · 2023Review
- HIV, syphilis, and hepatitis B virus infection and male circumcision in five Sub-Saharan African countries: Findings from the Population-based HIV Impact Assessment surveys, 2015-2019.PLOS global public health · 2023Article
- How Does Voluntary Medical Male Circumcision Reduce HIV Risk?Current HIV/AIDS reports · 2022Review
- Defining the Global Research and Programmatic Agenda and Priority Actions for Voluntary Medical Male Circumcision for HIV Prevention.Current HIV/AIDS reports · 2022Review
- Infant Circumcision for Sexually Transmitted Infection Risk Reduction Globally.Global health, science and practice · 2022Article
- Immune milieu and microbiome of the distal urethra in Ugandan men: impact of penile circumcision and implications for HIV susceptibility.Microbiome · 2022Article
- A pilot study to show that asymptomatic sexually transmitted infections alter the foreskin epithelial proteome.Frontiers in microbiology · 2022Article
- Evidence-based circumcision policy for Australia.Journal of men's health · 2022Article
- Semen: A modulator of female genital tract inflammation and a vector for HIV-1 transmission.American journal of reproductive immunology (New York, N.Y. : 1989) · 2021Review
- HIV Incidence by Male Circumcision Status From the Population-Based HIV Impact Assessment Surveys-Eight Sub-Saharan African Countries, 2015-2017.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Article
- Foreskin surface area is not associated with sub-preputial microbiome composition or penile cytokines.PloS one · 2020Article
- The Penile Microbiota in Uncircumcised and Circumcised Men: Relationships With HIV and Human Papillomavirus Infections and Cervicovaginal Microbiota.Frontiers in medicine · 2020Review
Corrections and comments
- Commented on by
Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
introductionMale circumcision reduces HIV acquisition in men. We assessed whether foreskin surface area was associated with HIV acquisition prior to circumcision.
methodsIn two randomized trials of male circumcision, the surface area of the foreskin was measured after surgery using standardized procedures. Nine hundred and sixty-five initially HIV-negative men were enrolled in a community cohort who subsequently enrolled in the male circumcision trials, provided 3920.8 person-years of observation prior to circumcision. We estimated HIV incidence per 100 person-years prior to circumcision, associated with foreskin surface area categorized into quartiles.
resultsMean foreskin surface area was significantly higher among men who acquired HIV (43.3 cm2, standard error 2.1) compared with men who remained uninfected (36.8 cm, standard error 0.5, P = 0.01). HIV incidence was 0.80/100 person-years (8/994.9 person-years) for men with foreskin surface areas in the lowest quartile (< or =26.3 cm2), 0.92/100 person-years (9/975.3 person-years) with foreskin areas in the second quartile (26.4-35.0 cm2), 0.90/100 person-years (8/888.5 person-years) with foreskin area in the third quartile (35.2-45.5 cm2) and 2.48/100 person-years (23/926.8 person-years) in men with foreskin surfaces areas in the highest quartile (>45.6 cm2). Compared with men with foreskin surface areas in the lowest quartile, the adjusted incidence rate ratio of HIV acquisition was 2.37 (95% confidence interval 1.05-5.31) in men with the largest quartile of foreskin surface area.
conclusionThe risk of male HIV acquisition is increased among men with larger foreskin surface areas.
Indexed as
Identifiers
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.