Circumcision as a primary HIV preventive: extrapolating from the available data

Global Public Health
R S Van Howe

Abstract

Billions of dollars to circumcise millions of African males as an HIV infection prevention have been sought, yet the effectiveness of circumcision has not been demonstrated. Data from 109 populations comparing HIV prevalence and incidence in men based on circumcision status were evaluated using meta-regression. The impact on the association between circumcision and HIV incidence/prevalence of the HIV risk profile of the population, the circumcision rates within the population and whether the population was in Africa were assessed. No significant difference in the risk of HIV infection based on the circumcision status was seen in general populations. Studies of high-risk populations and populations with a higher prevalence of male circumcision reported significantly greater odds ratios (odds of intact man having HIV) (p < .0001). When adjusted for the impact of a high-risk population and the circumcision rate of the population, the baseline odds ratio was 0.78 (95% CI = 0.56-1.09). No consistent association between presence of HIV infection and circumcision status of adult males in general populations was found. When adjusted for other factors, having a foreskin was not a significant risk factor. This undermines the justificatio...Continue Reading

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Citations

Aug 14, 2015·Israel Journal of Health Policy Research·Brian J Morris, Jeffrey D Klausner
Oct 15, 2019·Journal of Biosocial Science·Michel Garenne, Alan Matthews
Feb 8, 2019·Global Health Action·Peter ByassStig Wall
Sep 10, 2019·Journal of Evidence-based Medicine·Brian J MorrisJohn N Krieger

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Methods Mentioned

BETA
circumcision
circumcisions

Software Mentioned

SAS

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