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Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis.
BJU Int. 2018 04; 121(4):515-526.BI

Abstract

We aimed to assess male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition in heterosexual and homosexual men using all available data. A systematic literature review was conducted searching for studies that assessed male circumcision as a method to prevent HIV acquisition in homosexual and/or heterosexual men. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov were searched in March 2017. A random effects model was used to calculate a pooled risk ratio (RR) and its associated 95% confidence interval (CI). In total, 49 studies were included in this meta-analysis. The overall pooled RR for both homosexual and heterosexual men was 0.58 (95% CI 0.48-0.70), suggesting that circumcision was associated with a reduction in HIV risk. Circumcision was found to be protective for both homosexual and heterosexual men (RR: 0.80, 95% CI 0.69-0.92 and 0.28, 95% CI 0.14-0.59, respectively). Heterosexual men had a greater RR reduction (72% compared with 20% for homosexual men). There was significant heterogeneity among the studies (χ2 = 1378.34, df = 48; I2 = 97%). This meta-analysis shows that male circumcision was effective in reducing HIV risk for both heterosexual and homosexual men.

Authors+Show Affiliations

GKT School of Medical Education, King's College London, London, UK.Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.Department of Urology, Guy's and St Thomas' NHS Trust, London, UK.Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29232046

Citation

Sharma, Sanjeev C., et al. "Male Circumcision for the Prevention of Human Immunodeficiency Virus (HIV) Acquisition: a Meta-analysis." BJU International, vol. 121, no. 4, 2018, pp. 515-526.
Sharma SC, Raison N, Khan S, et al. Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis. BJU Int. 2018;121(4):515-526.
Sharma, S. C., Raison, N., Khan, S., Shabbir, M., Dasgupta, P., & Ahmed, K. (2018). Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis. BJU International, 121(4), 515-526. https://doi.org/10.1111/bju.14102
Sharma SC, et al. Male Circumcision for the Prevention of Human Immunodeficiency Virus (HIV) Acquisition: a Meta-analysis. BJU Int. 2018;121(4):515-526. PubMed PMID: 29232046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis. AU - Sharma,Sanjeev C, AU - Raison,Nicholas, AU - Khan,Shamim, AU - Shabbir,Majid, AU - Dasgupta,Prokar, AU - Ahmed,Kamran, Y1 - 2018/01/29/ PY - 2017/12/13/pubmed PY - 2018/10/16/medline PY - 2017/12/13/entrez KW - circumcision KW - human immunodeficiency virus KW - prevention KW - voluntary medical male circumcision SP - 515 EP - 526 JF - BJU international JO - BJU Int VL - 121 IS - 4 N2 - We aimed to assess male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition in heterosexual and homosexual men using all available data. A systematic literature review was conducted searching for studies that assessed male circumcision as a method to prevent HIV acquisition in homosexual and/or heterosexual men. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov were searched in March 2017. A random effects model was used to calculate a pooled risk ratio (RR) and its associated 95% confidence interval (CI). In total, 49 studies were included in this meta-analysis. The overall pooled RR for both homosexual and heterosexual men was 0.58 (95% CI 0.48-0.70), suggesting that circumcision was associated with a reduction in HIV risk. Circumcision was found to be protective for both homosexual and heterosexual men (RR: 0.80, 95% CI 0.69-0.92 and 0.28, 95% CI 0.14-0.59, respectively). Heterosexual men had a greater RR reduction (72% compared with 20% for homosexual men). There was significant heterogeneity among the studies (χ2 = 1378.34, df = 48; I2 = 97%). This meta-analysis shows that male circumcision was effective in reducing HIV risk for both heterosexual and homosexual men. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/29232046/Male_circumcision_for_the_prevention_of_human_immunodeficiency_virus__HIV__acquisition:_a_meta_analysis_ L2 - https://doi.org/10.1111/bju.14102 DB - PRIME DP - Unbound Medicine ER -