Trial reportAIDS (London, England)2012
Circumcision status and incident herpes simplex virus type 2 infection, genital ulcer disease, and HIV infection.
Trial report in AIDS (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 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
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Critical evaluation of arguments opposing male circumcision: A systematic review.Journal of evidence-based medicine · 2019Pooled it
- Sexually transmitted diseases treatment guidelines, 2015.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2015Guideline
- Adult male circumcision with a circular stapler versus conventional circumcision: A prospective randomized clinical trial.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 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
- Medical male circumcision and herpes simplex virus 2 acquisition: posttrial surveillance in Kisumu, Kenya.The Journal of infectious diseases · 2013Trial
- 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
- 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
- What is the medical evidence on non-therapeutic child circumcision?International journal of impotence research · 2023Review
- Infant Circumcision for Sexually Transmitted Infection Risk Reduction Globally.Global health, science and practice · 2022Article
- Genitourinary Infections Related to Circumcision and the Potential Impact on Male Infertility.The world journal of men's health · 2022Review
- The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated-A Critical Review.Viruses · 2022Review
- Evidence-based circumcision policy for Australia.Journal of men's health · 2022Article
- Article
- The antiviral activity of arbidol hydrochloride against herpes simplex virus type II (HSV-2) in a mouse model of vaginitis.International immunopharmacology · 2019Article
- Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version).Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2018Article
- 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
- Microbial Diversity of Genital Ulcers of HSV-2 Seropositive Women.Scientific reports · 2017Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
Abstract
objectiveWe assessed the protective effect of medical male circumcision (MMC) against HIV, herpes simplex virus type 2 (HSV-2), and genital ulcer disease (GUD) incidence.
designTwo thousand, seven hundred and eighty-seven men aged 18-24 years living in Kisumu, Kenya were randomly assigned to circumcision (n=1391) or delayed circumcision (n=1393) and assessed by HIV and HSV-2 testing and medical examinations during follow-ups at 1, 3, 6, 12, 18, and 24 months.
methodsCox regression estimated the risk ratio of each outcome (incident HIV, GUD, HSV-2) for circumcision status and multivariable models estimated HIV risk associated with HSV-2, GUD, and circumcision status as time-varying covariates.
resultsHIV incidence was 1.42 per 100 person-years. Circumcision was 62% protective against HIV [risk ratio=0.38; 95% confidence interval (CI) 0.22-0.67] and did not change when controlling for HSV-2 and GUD (risk ratio=0.39; 95% CI 0.23-0.69). GUD incidence was halved among circumcised men (risk ratio=0.52; 95% CI 0.37-0.73). HSV-2 incidence did not differ by circumcision status (risk ratio=0.94; 95% CI 0.70-1.25). In the multivariable model, HIV seroconversions were tripled (risk ratio=3.44; 95% CI 1.52-7.80) among men with incident HSV-2 and seven times greater (risk ratio=6.98; 95% CI 3.50-13.9) for men with GUD.
conclusionContrary to findings from the South African and Ugandan trials, the protective effect of MMC against HIV was independent of GUD and HSV-2, and MMC had no effect on HSV-2 incidence. Determining the causes of GUD is necessary to reduce associated HIV risk and to understand how circumcision confers protection against GUD and HIV.
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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.