Evidence map›Paper›PMID 30879508›Full record

SynthesisThe Lancet. Global health2019

Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data.

Tanwei Yuan, Thomas Fitzpatrick, Nai-Ying Ko, Yong Cai, Yingqing Chen, Jin Zhao, Linghua Li, Junjie Xu, Jing Gu, Jinghua Li and 11 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 9 pooled it
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 9 syntheses or guidelines pooled it, 120 citations in OpenAlex.

  1. Circumcision for HIV Prevention in Men Who Have Sex With Men: An Updated Meta-Analysis.Journal of acquired immune deficiency syndromes (1999) · 2026
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Timing of Goals of Care Discussions in Nursing Homes: A Systematic Review.Journal of the American Medical Directors Association · 2023
    Pooled it
  6. Pooled it
  7. Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021
    Guideline
  8. Pooled it
  9. Pooled it
  10. Trial
  11. Trial
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 12 institutions in 4 countries.

Tanwei YuanSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Thomas FitzpatrickSchool of Medicine, University of Washington, Seattle, WA, USA.
Nai-Ying KoDepartment of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Yong CaiSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yingqing ChenDepartment of Biostatistics, University of Washington, Seattle, WA, USA; Vaccine and Infectious Disease Division and Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Jin ZhaoShenzhen Center for Disease Control and Prevention, Shenzhen, China.
Linghua LiGuangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Junjie XuKey Laboratory of AIDS Immunology of the National Health and Family Planning Commission, the First Affiliated Hospital, China Medical University, Shenyang, China.
Jing GuSchool of Public Health, and Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
Jinghua LiSchool of Public Health, and Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
Chun HaoSchool of Public Health, and Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
Zhengrong YangShenzhen Center for Disease Control and Prevention, Shenzhen, China.
Weiping CaiGuangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Chien-Yu ChengTaoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Zhenzhou LuoShenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China.
Kechun ZhangShenzhen Longhua Center for Disease Control and Prevention, Shenzhen, China.
Guohui WuChongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
Xiaojun MengWuxi Municipal Center for Disease Control and Prevention, Wuxi, China.
Andrew E GrulichKirby Institute, University of New South Wales, Sydney, NSW, Australia.
Yuantao HaoSchool of Public Health, and Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
Huachun ZouSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; Shenzhen Center for Disease Control and Prevention, Shenzhen, China; School of Public Health, and Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China; Kirby Institute, University of New South Wales, Sydney, NSW, Australia. Electronic address: zouhuachun@mail.sysu.edu.cn.
Sun Yat-sen University · CNShenzhen Center for Disease Control and Prevention · CNUNSW Sydney · AUChina Medical University · CNFred Hutch Cancer Center · USGuangzhou Eighth People's Hospital · CNGuangzhou Medical University · CNMinistry of Health and Welfare · TWNational Cheng Kung University Hospital · TWShanghai Jiao Tong University · CNShenzhen Nanshan Center for Chronic Disease Control · CNUniversity of Washington · US

Funding

Statistical Methods for Adherence Issues in HIV Prevention ResearchR01AI121259 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI CHEN, YING QING · 2015 to 2018
$2.5M
Statistical Methods for Combination HIV Prevention ApproachesR01MH105857 · NIMH · FRED HUTCHINSON CANCER RESEARCH CENTER · PI CHEN, YING QING · 2014 to 2018
$2.4M
Methods for Complex Longitudinal Data in HIV/AIDS Prevention ResearchR56AI140953 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI CHEN, YING QING · 2018 to 2018
$657k
NIAID NIH HHS R01 AI121259NIAID NIH HHS R56 AI140953NIMH NIH HHS R01 MH105857
6 · The paper itself

Abstract

backgroundMen who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. Previous reviews investigating the role of circumcision in preventing HIV and other STIs among MSM were inconclusive. Many new studies have emerged in the past decade. To inform global prevention strategies for HIV and other STIs among MSM, we reviewed all available evidence on the associations between circumcision and HIV and other STIs among MSM.

methodsIn this systematic review and meta-analysis, we searched PubMed, Web of Science, BioMed Central, Scopus, ResearchGate, Cochrane Library, Embase, PsycINFO, Google Scholar, and websites of international HIV and STI conferences for studies published before March 8, 2018. Interventional or observational studies containing original quantitative data describing associations between circumcision and incident or prevalent infection of HIV and other STIs among MSM were included. Studies were excluded if MSM could not be distinguished from men who have sex with women only. We calculated pooled odds ratios (ORs) and their 95% CIs using random-effect models. We assessed risk of bias using the Newcastle-Ottawa scale.

findingsWe identified 62 observational studies including 119 248 MSM. Circumcision was associated with 23% reduced odds of HIV infection among MSM overall (OR 0·77, 95% CI 0·67-0·89; number of estimates [k]=45; heterogeneity I

interpretationWe found evidence that circumcision is likely to protect MSM from HIV infection, particularly in countries of low and middle income. Circumcision might also protect MSM from HSV and penile HPV infection. MSM should be included in campaigns promoting circumcision among men in countries of low and middle income. In view of the substantial proportion of MSM in countries of low and middle income who also have sex with women, well designed longitudinal studies differentiating MSM only and bisexual men are needed to clarify the effect of circumcision on male-to-male transmission of HIV and other STIs.

fundingNational Natural Science Foundation of China, National Science and Technology Major Project of China, Australian National Health and Medical Research Council Early Career Fellowship, Sanming Project of Medicine in Shenzhen, National Institutes of Health, Mega Projects of National Science Research for the 13th Five-Year Plan, Doris Duke Charitable Foundation.

Indexed as

Circumcision, MaleHerpes SimplexHIV InfectionsHomosexuality, MaleHumansMaleSexual BehaviorSexually Transmitted Diseases

Identifiers

PMID30879508
PMCPMC7779827
OpenAlexW2921398057

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.