{"id":363,"date":"2012-04-13T16:00:34","date_gmt":"2012-04-13T16:00:34","guid":{"rendered":"http:\/\/circinfosite.com\/?page_id=363"},"modified":"2013-07-14T20:13:48","modified_gmt":"2013-07-14T20:13:48","slug":"circumcision-does-not-prevent-hiv","status":"publish","type":"page","link":"http:\/\/circinfosite.com\/index.php\/facts-and-myths\/circumcision-does-not-prevent-hiv\/","title":{"rendered":"Circumcision and HIV"},"content":{"rendered":"<p><script type=\"text\/javascript\">\/\/ <![CDATA[\n(function(d, s, id) {\n  var js, fjs = d.getElementsByTagName(s)[0];\n  if (d.getElementById(id)) return;\n  js = d.createElement(s); js.id = id;\n  js.src = \"\/\/connect.facebook.net\/en_US\/all.js#xfbml=1\";\n  fjs.parentNode.insertBefore(js, fjs);\n}(document, 'script', 'facebook-jssdk'));\n\/\/ ]]><\/script><\/p>\n<h3>Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns.\u00a0<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=Boyle%20GJ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22320006\">Boyle GJ<\/a>\u00a0<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=Hill%20G%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22320006\">Hill G<\/a><\/h3>\n<h3>Abstract<\/h3>\n<div>\n<p>In 2007, WHO\/UNAIDS recommended male circumcision as an HIV-preventive measure based on three sub-Saharan African randomised clinical trials (RCTs) into female-to-male sexual transmission. A related RCT investigated male-to-female transmission. However, the trials were compromised by inadequate equipoise; selection bias; inadequate blinding; problematic randomisation; trials stopped early with exaggerated treatment effects; and not investigating non-sexual transmission. Several questions remain unanswered. Why were the trials carried out in countries where more intact men were HIV-positive than in those where more circumcised men were HIV-positive? Why were men sampled from specific ethnic subgroups? Why were so many participants lost to follow-up? Why did men in the male circumcision groups receive additional counselling on safe sex practices? While the absolute reduction in HIV transmission associated with male circumcision across the three female-to-male trials was only about 1.3%, relative reduction was reported as 60%, but, after correction for lead-time bias, averaged 49%. In the Kenyan trial, male circumcision appears to have been associated with four new incident infections. In the Ugandan male-to-female trial, there appears to have been a 61% relative increase in HIV infection among female partners of HIV-positive circumcised men. Since male circumcision diverts resources from known preventive measures and increases risk-taking behaviours, any long-term benefit in reducing HIV transmission remains uncertain.<\/p>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22320006\" target=\"_blank\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22320006<\/a><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns.\u00a0Boyle GJ\u00a0Hill G Abstract In 2007, WHO\/UNAIDS recommended male circumcision as an HIV-preventive measure based on three sub-Saharan African randomised clinical trials (RCTs) into female-to-male&hellip; <\/p>\n","protected":false},"author":1,"featured_media":0,"parent":438,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-363","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/pages\/363","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/comments?post=363"}],"version-history":[{"count":13,"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/pages\/363\/revisions"}],"predecessor-version":[{"id":367,"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/pages\/363\/revisions\/367"}],"up":[{"embeddable":true,"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/pages\/438"}],"wp:attachment":[{"href":"http:\/\/circinfosite.com\/index.php\/wp-json\/wp\/v2\/media?parent=363"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}