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

o follow the participants over 21 months, testing them for HIV at months 3, 12 and 21, to see whether there was a difference in the rate of new infections between the two groups.

After 18 months, the number of new HIV infections in the control group was 49, compared with 20 in the treatment group. The results suggested that circumcision can reduce female-to-male HIV infection by about 60% (95% CI: 32%?6%).

The committee monitoring this study considered that the protective effect of male circumcision was so large that it would be unethical to continue the study. The trial was therefore stopped and the uncircumcised men were offered circumcision.

The trial, results of which were first reported at an international AIDS conference in July, has attracted huge attention among the global health community.

Bertran Auvert and his co-authors have called for the promotion of male circumcision as part of AIDS prevention efforts in Orange Farm and in other parts of Africa. However, other HIV experts take a more cautious view, believing that the results of this one study must be confirmed by further studies before action can be recommended, especially given the relatively small number of new infections (20 among the circumcised men versus 49 among the controls) and the relatively large number of men who did not return for all the follow-up testing (100 and 125, respectively).

In a statement (http://www.who.int/mediacentre/news/releases/2005/pr32/en/) published shortly after Auvert and colleagues' trial was presented at the July conference, UNAIDS emphasized that "although the trial shows promising protective effects of adult male circumcision in HIV acquisition, more research is needed to confirm the reproducibility of the findings and of this trial and whether or not the results have more general application."

Furthermore, adult circumcision carries
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Source:Public Library of Science


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