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Circumcision and HIV infection: assessment of causality.
AIDS Behav. 2008 Nov; 12(6):835-41.AB

Abstract

Whether the observed association between male circumcision and HIV infection is causal or not has not been verified. We did a meta-analysis of published data and applied Hill's criteria for causality on all available evidence to assess presence of a causal association. Analysis was by the random effects method. Summary estimates were calculated for all studies combined and for sub groups stratified by type of study population, study design, and method of ascertaining circumcision status. Thirteen studies were included. Circumcised men had a reduced risk for HIV infection (adjusted RRoverall = 0.42, 95% CI 0.33-0.53; RR(RCT) = 0.43 95% CI 0.32-0.59, RRobservational = 0.39, 95% CI 0.27-0.56). Available evidence satisfies six of Hill's criteria: strength of association, consistency, temporality, coherence, biological plausibility, and experiment. These results provide unequivocal evidence that circumcision plays a causal role in reducing the risk of HIV infection among men.

Authors+Show Affiliations

Division of Epidemiology, School of Public Health, University of California Berkeley, 101 Haviland Hall, MC #7358, Berkeley, CA 94720-7358, USA. tusiimej@berkeley.edu

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

18800244

Citation

Byakika-Tusiime, Jayne. "Circumcision and HIV Infection: Assessment of Causality." AIDS and Behavior, vol. 12, no. 6, 2008, pp. 835-41.
Byakika-Tusiime J. Circumcision and HIV infection: assessment of causality. AIDS Behav. 2008;12(6):835-41.
Byakika-Tusiime, J. (2008). Circumcision and HIV infection: assessment of causality. AIDS and Behavior, 12(6), 835-41. https://doi.org/10.1007/s10461-008-9453-6
Byakika-Tusiime J. Circumcision and HIV Infection: Assessment of Causality. AIDS Behav. 2008;12(6):835-41. PubMed PMID: 18800244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circumcision and HIV infection: assessment of causality. A1 - Byakika-Tusiime,Jayne, Y1 - 2008/09/18/ PY - 2008/04/10/received PY - 2008/08/20/accepted PY - 2008/9/19/pubmed PY - 2008/12/18/medline PY - 2008/9/19/entrez SP - 835 EP - 41 JF - AIDS and behavior JO - AIDS Behav VL - 12 IS - 6 N2 - Whether the observed association between male circumcision and HIV infection is causal or not has not been verified. We did a meta-analysis of published data and applied Hill's criteria for causality on all available evidence to assess presence of a causal association. Analysis was by the random effects method. Summary estimates were calculated for all studies combined and for sub groups stratified by type of study population, study design, and method of ascertaining circumcision status. Thirteen studies were included. Circumcised men had a reduced risk for HIV infection (adjusted RRoverall = 0.42, 95% CI 0.33-0.53; RR(RCT) = 0.43 95% CI 0.32-0.59, RRobservational = 0.39, 95% CI 0.27-0.56). Available evidence satisfies six of Hill's criteria: strength of association, consistency, temporality, coherence, biological plausibility, and experiment. These results provide unequivocal evidence that circumcision plays a causal role in reducing the risk of HIV infection among men. SN - 1573-3254 UR - https://www.unboundmedicine.com/medline/citation/18800244/Circumcision_and_HIV_infection:_assessment_of_causality_ L2 - https://doi.org/10.1007/s10461-008-9453-6 DB - PRIME DP - Unbound Medicine ER -