Evidence map›Paper›PMID 36308579›Full record

ReviewCurrent HIV/AIDS reports2022

How Does Voluntary Medical Male Circumcision Reduce HIV Risk?

Jessica L Prodger, Ronald M Galiwango, Aaron A R Tobian, Daniel Park, Cindy M Liu, Rupert Kaul

Open access · bronzeAbstract readReview
In one paragraph

Review in Current HIV/AIDS reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.9field-weighted citation impact, top 6% 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

9 citing papers in PubMed, 18 citations in OpenAlex.

  1. HIV Transmission and Immunology of the Male Reproductive Tract.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026
    Review
  2. Observational
  3. Article
  4. Review
  5. Men undergoing medical circumcision at a community health centre: Knowledge and attitudes.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025
    Article
  6. Review
  7. Article
  8. Article
  9. HIV infection.Nature reviews. Disease primers · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 3 countries.

Jessica L Prodger *Departments of Microbiology and Immunology and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A 5C1, Canada.
Ronald M Galiwango *Rakai Health Sciences Program, Kalisizo, Uganda.
Aaron A R TobianDepartment of Pathology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA.
Daniel ParkDepartment of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA.
Cindy M LiuDepartment of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA.
Rupert KaulDepartments of Medicine and Immunology, University of Toronto, Medical Sciences Building Rm. 6356, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada. rupert.kaul@utoronto.ca.ORCID 0000-0002-1586-4093
Milken Institute · USJohns Hopkins University · USRakai Health Sciences Program · UGUniversity of New Brunswick · CAWestern University · CA

Funding

The role of penile bacteria and inflammation in HIV susceptibility; Rakai, UgandaR01AI123002 · NIAID · GEORGE WASHINGTON UNIVERSITY · PI LIU, CINDY · 2016 to 2020
$3.3M
How sex, host microenvironment, and immune responses shape acquisition of genital bacteria that increase HIV riskR01DK131936 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI Cindy Liu · 2022 to 2026
$3.0M
Penile Microbiome, Inflammation and HIV Susceptibility During Sexual Debut and Maturation Among Male AdolescentsR01AI128779 · NIAID · JOHNS HOPKINS UNIVERSITY · PI TOBIAN, AARON A · 2017 to 2020
$2.1M
NIAID NIH HHS R01 AI123002NIAID NIH HHS R01 AI128779NIDDK NIH HHS R01 DK131936NIDDK NIH HHS R01-DK131936-01
6 · The paper itself

Abstract

purpose of reviewVoluntary medical male circumcision (VMMC) is a surgical procedure that reduces HIV acquisition risk by almost two-thirds. However, global implementation is lagging, in part due to VMMC hesitancy. A better understanding of the mechanism(s) by which this procedure protects against HIV may increase acceptance of VMMC as an HIV risk reduction approach among health care providers and their clients. RECENT

findingsHIV acquisition in the uncircumcised penis occurs preferentially across the inner foreskin tissues, due to increased susceptibility that is linked to elevated inflammatory cytokine levels in the sub-preputial space and an increased tissue density of HIV-susceptible CD4 + T cells. Inflammation can be caused by sexually transmitted infections, but is more commonly induced by specific anaerobic components of the penile microbiome. Circumcision protects by both directly removing the susceptible tissues of the inner foreskin, and by inducing a less inflammatory residual penile microbiome. VMMC reduces HIV susceptibility by removing susceptible penile tissues, and also through impacts on the penile immune and microbial milieu. Understanding these mechanisms may not only increase VMMC acceptability and reinvigorate global VMMC programs, but may also lead to non-surgical HIV prevention approaches focused on penile immunology and/or microbiota.

Indexed as

Circumcision, MaleHIV InfectionsSexually Transmitted DiseasesForeskinHumansMalePenisHIV susceptibilityMicrobiomeMucosal immunologyPenile circumcision

Identifiers

PMID36308579
PMCPMC9617235
OpenAlexW4307959959

What OpenQuestion holds

Textmetadata
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.