Evidence map›Paper›PMID 33939956›Full record

SynthesisThe Lancet. Global health2021

Association between medical male circumcision and HIV risk compensation among heterosexual men: a systematic review and meta-analysis.

Yanxiao Gao, Tanwei Yuan, Yuewei Zhan, Han-Zhu Qian, Yinghui Sun, Weiran Zheng, Leiwen Fu, Bowen Liang, Zhiqiang Zhu, Lin Ouyang and 11 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Yanxiao GaoSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Tanwei YuanSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Yuewei ZhanSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Han-Zhu QianXiangya Nursing School, Central South University, Changsha, China; Yale School of Public Health, Yale University, New Haven, CT, USA.
Yinghui SunSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Weiran ZhengSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Leiwen FuSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Bowen LiangSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Zhiqiang ZhuDepartment of Urology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Lin OuyangChongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
Min LiuDepartment of Urology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Thomas FitzpatrickSchool of Medicine, University of Washington, Seattle, WA, USA.
Zunyou WuChinese Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaojun MengWuxi Municipal Center for Disease Control and Prevention, Wuxi, China.
Jared M BaetenDepartment of Global Health, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
Jin ZhaoShenzhen Municipal Center for Disease Control and Prevention, Shenzhen, China.
Sten H VermundYale School of Public Health, Yale University, New Haven, CT, USA.
Maohe YuTianjin Municipal Center for Disease Control and Prevention, Tianjin, China.
Guohui WuChongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
Bin SuBeijing Key Laboratory for HIV/AIDS Research, Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Huachun ZouSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; Kirby Institute, University of New South Wales, Sydney, NSW, Australia; School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zouhuachun@mail.sysu.edu.cn.

Funding

Using Coincidence Analysis to Investigate Factors Affecting PrEP Initiation and Continuation in Southern ending the Epidemic CountiesP30MH062294 · NIMH · YALE UNIVERSITY · PI E. Jennifer Edelman · 2001 to 2026
$48.5M
NIMH NIH HHS P30 MH062294
6 · The paper itself

Abstract

backgroundMedical male circumcision (MMC) reduces HIV infection among heterosexual men. There are concerns MMC might prompt higher-risk sexual behaviours because of lower self-perceived risk of HIV infection. We reviewed the published literature to examine associations between MMC and both condom use and number of sex partners among heterosexual men.

methodsIn this systematic review and meta-analysis, we searched PubMed, Embase, and the Cochrane Library for studies published before Nov 15, 2020. Interventional and observational studies were included if they contained original quantitative data describing the association between MMC and condom use or number of sex partners among heterosexual men. We excluded data from men whose circumcisions were ritual or religious and data from men who have sex with men. We extracted odds ratios (ORs) and 95% CIs for the associations between MMC and condomless sex and MMC and multiple sex partners directly from the publications if available, selecting adjusted ORs when provided; when necessary, we calculated ORs and 95% CIs using original study data provided in the publication. We used the Mantel-Haenszel random effects model to calculate pooled ORs and 95% CIs.

findingsOur search yielded 3035 results, of which 471 were duplicates and 2537 did not meet the inclusion criteria. From the remaining 27 eligible studies, we identified 99 292 men from 31 independent population samples. 24 studies were done in Africa. We found no statistically significant associations between MMC and condomless sex (OR 0·91, 95% CI 0·80-1·05; k=30; I

interpretationThe promotion of circumcision as an HIV preventive measure does not appear to increase higher-risk sexual behaviours in heterosexual men. Ongoing sexual health education should be maintained as a vital component of effective MMC programmes.

fundingNational Science and Technology Major Project of China, the Fundamental Research Funds for the Central Universities, and the Shenzhen Science and Technology Innovation Commission Basic Research Program.

Indexed as

Health Risk BehaviorsCircumcision, MaleCondomsHeterosexualityHIV InfectionsHumansMaleRandomized Controlled Trials as TopicSexual BehaviorSexual Partners

Identifiers

PMID33939956
PMCPMC8690595

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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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.