Table 1. Summary table of correlation of male circumcision status and HIV acquisition.
Study/ study design | sites | population | size analyzed in cir./unc. group | follow up duration | proportion with circumcised male | HIV(+) rate in circumcised group | HIV(+) rate in uncircumcised group | Unadjusted RR# (95% CI & ) | Adjusted RR(95% CI) |
---|---|---|---|---|---|---|---|---|---|
Studies concerning HIV acquisition from female to male | |||||||||
Auvert2005 /RCT | South Africa | male of general population | 1546/1582 | 21mons | 49% | 0.85 per 100 pyo* | 2.1 per 100 pyo | 0.40 (0.24–0.68) | 0.39 (0.23–0.66)○ |
Bailey2007 /RCT | Kisumu, Kenya | HIV(-) male | 1391/1393 | 24mons | 50% | 2.1% (1.2–3.0) | 4.2% (3.0–5.4) | 0.47 (0.28–0.78) | 0.41 (0.24–0.70)◎ |
Gray2007 /RCT | Rakai, Uganda | HIV(-) male | 2474/2522 | 24mons | 50% | 0.66 per 100 pyo | 1.33 per 100 pyo | 0.49 (0.28–0.84) | 0.49 (0.29–0.81)⊕ |
Cameron1989 /P. Cohort | Nairobi, Kenya | STD clinic visitors | 214/79 | № | 73% | № | № | 0.10 (0.04–0.22) | 0.12 (0.04–0.33)♂ |
Lavreys1999 /P. Cohort | Mombasa,Kenya | HIV(-) male | 651/95 | 20mons | 13% | 2.50 per 100 pyo | 1.8 per 100 pyo | 0.42 (0.22–0.81) | № |
Wawer1999 /P. Cohort | Rakai, Uganda | Subgroup1(S1): HIV(-) male | 409/1635 | 20mons | 20% | 1.40 per 100 pyo | № | 0.97 (0.36–2.25) | № |
№ | Subgroup2(S2): HIV(-) male | 346/1961 | 20mons | 15% | 0.70 per 100 pyo | № | 0.45 (0.09–1.40) | № | |
Ronaid2000 /P. Cohort | Rakai, Uganda | HIV(-) male | 908/4608 | 49mons | 16% | 1.10 per 100 pyo | 1.8 per 100 pyo | 0.61 (0.37–0.97) | 0.53(0.33–0.87))⊙ |
Reynolds2004 /P. Cohort | Pune, India | HIV(-) male | 191/2107 | 12mons | 8% | 0.70 per 100 pyo | 5.50 per 100 pyo | 0.13 (0.02–0.47) | 0.15 (0.04–0.62)♀ |
Gray2012/P. Cohort | Rakai, Uganda | HIV(-) male | 3198/402 | 4.79years | 89% | 0.50 per 100 pyo | 1.93per 100 pyo | 0.27 (0.16–0.44) | 0.27 (0.16–0.45)☆ |
Studies concerning HIV acquisition from male to female | |||||||||
Wawer2009 /RCT | Rakai, Uganda | Female with HIV(+) partners | 92/67 | 24mons | 58% | 18% (17/92) | 12% (8/67) | 1.58 (0.68–3.66) | 1.49 (0.62–3.57)※ |
Kapiga1998 /P. Cohort | Dar es Salaam, Tanzania | Family planning clinic visitors | 1022/22 | 34mons | 98% | 2.60 per 100 pyo | 9.20 per 100 pyo | 0.28 (0.09–0.89) | 0.29 (0.09–0.97)▽ |
Reynolds2006 /P. Cohort | Rakai, Uganda | Couples with HIV(+)males | № | № | 13% | 6.60 per 100 pyo | 10.3 per 100 pyo | 0.67 (0.45–1.00) | № |
Turner2007 /P. Cohort | Zimbabwe | Family planning clinic visitors/STD clinic visitors/sex workers | 989/3249 | 24mons | 30% | 2.03 per 100 pyo | 2.96 per 100 pyo | 0.69 (0.48–0.99) | 0.78 (0.53–1.14)◇ |
Baeten2010/P. Cohort | 14 sites in east/southern Africa | Couples with HIV(+) males | 374/722 | 24mons | 34% | 2.72 per 100 pyo | 4.38 per 100 pyo | 0.62 (0.35–1.10) | 0.56 (0.30–1.05)§ |
RCT: randomised controlled trial. P. Cohort: prospective cohort study.
*Person-years of observation.
#Risk ratio is incidence rate (or hazard) ratios for RCT and Cohort shown.
&Confidence interval.
○Hazard ratio adjusted for sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behavior.
◎Hazard ratio adjusted for non-adherence to treatment and excluding four men found to be seropositive at enrolment.
⊕Rate ratio adjusted for age, marital status, and sexual risk behaviours at enrolment.
♂Adjusting factors were not achieved.
⊙Rate ratio adjusted for age, marital status, sexual partners in past year, sex for money, condom use and syphilis.
♀Rate ratio adjusted for Hindu/non-Hindu religion, level of education, living with family; and time-dependent covariates: calendar year,age group, marital status, multiple sex partners, number of female sex-worker partners (0, 1, 2–9, or10~), condom use, tattoos, and medical injections.
☆Hazard Ratio adjusted for sociodemographic characteristics at the last trial visit and time-dependent sexual behaviors during posttrial follow up.
※Hazard ratio adjusted for age and condom useage.
▽Rate ratio adjusted for age, marital status, gonorrhea/candidiasis at baseline, number of sexual partners and alcohol consumption during the follow-up period.
◇Hazard ratio adjusted for age, age at coital debut, contraceptive method, husband′s employment status, education, number of partners in past 3 months, and a product-interaction term between time and number of partners in past 3 months.
§Hazard ratio adjusted for male partner HIV-1 plasma viral load and censored at male partner antiretroviral therapy initiation.
№Dates were not available.