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PLoS Medicine publishes first trial of effect of male circumcision on HIV infection

The peer-reviewed results of the first trial of the effect of male circumcision on HIV infection, which some experts call "a landmark trial," will be published in PLoS Medicine on October 25. The trial found that circumcision reduced the rate of new infections among heterosexual men in South Africa by about 60%.

Because HIV infection rates are generally lower among African groups where circumcision is a traditional practice, compared with largely non-circumcised populations, researchers had suspected that circumcision might offer some protection against HIV transmission. However, because the lower infection rates in the circumcised groups might be due to some other difference between circumcised and uncircumcised populations, the only way to test whether circumcision has a protective effect is a randomized intervention study. Such trials are under way in Uganda and in Kenya but the trial reported in PLoS Medicine is the first to be completed, peer-reviewed, and published in a medical journal. The large protective effect of male circumcision observed has surprised many HIV experts, and it will be important to see whether the related studies under way confirm the results of this trial.

The trial, conducted by a team of French and South African researchers and sponsored by ANRS (the French National Agency of Research on AIDS), took place in the Orange Farm area near Johannesburg, where male circumcision in adulthood is a common but not universal practice.

The researchers offered young sexually active uncircumcised heterosexual men the chance to be circumcised and then monitored for HIV infection. The participants (3,274 men) were randomly allocated to two different groups--one group was immediately circumcised and the other group was to remain uncircumcised until after the completion of the trial 21 months later. The circumcised men were instructed to abstain from sexual activity for 6 weeks after the operation. The plan was t
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Source:Public Library of Science


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