Uptake of medical male circumcision with household-based testing, and the association of traditional male circumcision and HIV infection.
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pmc-release:
01
04
2024
pubmed:
3
2
2023
medline:
17
3
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Voluntary medical male circumcision (VMMC) is an important component of combination HIV prevention. Inclusion of traditionally circumcised HIV negative men in VMMC uptake campaigns may be important if traditional male circumcision is less protective against HIV acquisition than VMMC. We used data from the HIV Prevention Trials Network (HPTN) 071 (PopART) study. This cluster-randomized trial assessed the impact of a combination prevention package on population-level HIV incidence in 21 study communities in Zambia and South Africa. We evaluated uptake of VMMC, using a two-stage analysis approach and used discrete-time survival analysis to evaluate the association between the types of male circumcision and HIV incidence. A total of 10 803 HIV-negative men with self-reported circumcision status were included in this study. At baseline, 56% reported being uncircumcised, 26% traditionally circumcised and 18% were medically circumcised. During the PopART intervention, 11% of uncircumcised men reported uptake of medical male circumcision. We found no significant difference in the uptake of VMMC in communities receiving the PopART intervention package and standard of care {adj. rate ratio=1·10 [95% confidence interval (CI) 0.82, 1.50, P = 0.48]}. The rate of HIV acquisition for medically circumcised men was 70% lower than for those who were uncircumcised adjusted hazard ratio (adjHR) = 0.30 (95% CI 0.16-0.55; P < 0.0001). There was no difference in rate of HIV acquisition for traditionally circumcised men compared to those uncircumcised adjHR = 0.84 (95% CI 0.54, 1.31; P = 0.45). Household-based delivery of HIV testing followed by referral for medical male circumcision did not result in substantial VMMC uptake. Traditional circumcision is not associated with lower risk of HIV acquisition.
Identifiants
pubmed: 36727597
doi: 10.1097/QAD.0000000000003463
pii: 00002030-202304010-00012
pmc: PMC10023451
mid: NIHMS1857989
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
795-802Subventions
Organisme : NIAID NIH HHS
ID : UM1 AI068613
Pays : United States
Organisme : PEPFAR
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI068617
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI068619
Pays : United States
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Organisme : NIAID NIH HHS
ID : UM1 AI068617
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Références
Weiss H, World Health Organization, Joint United Nations Programme on HIV/AIDS, London School of Hygiene and Tropical Medicine, editors. Male circumcision: global trends and determinants of prevalence, safety, and acceptability . Geneva: World Health Organization: UNAIDS; 2008.
Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial . PLoS Med 2005; 2:e298.
Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial . Lancet 2007; 369:657–666.
Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial . Lancet Lond Engl 2007; 369:643–656.
WHO. New data on male circumcision and HIV prevention: policy and programme implications. WHO. Available at: https://www.who.int/hiv/pub/meetingreports/mc_montreux_march07/en/ [Accessed 8 July 2021].
Remarkable progress in the scale up of voluntary medical male circumcision as an HIV prevention intervention in 15 ESA countries. Available at: https://www.who.int/publications-detail-redirect/voluntary-medical-male-circumcision-progress-brief-2019 [Accessed 24 August 2021].
Atkins K, Yeh PT, Kennedy CE, Fonner VA, Sweat MD, O’Reilly KR, et al. Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: a systematic review . PLoS One 2020; 15:e0227755.
Barone MA, Li PS, Awori QD, Lee R, Goldstein M. Clinical trials using the Shang Ring device for male circumcision in Africa: a review . Transl Androl Urol 2014; 3:113–124.
Neonatal and child male circumcision: a global review. Available at: https://www.who.int/hiv/pub/malecircumcision/neonatal_child_MC_UNAIDS.pdf [Accessed 28 September 2021].
Cork MA, Wilson KF, Perkins S, Collison ML, Deshpande A, Eaton JW, et al. Mapping male circumcision for HIV prevention efforts in sub-Saharan Africa . BMC Med 2020; 18:189.
Garenne M, Matthews A. Voluntary medical male circumcision and HIV in Zambia: expectations and observations . J Biosoc Sci 2020; 52:560–572.
Maughan-Brown B, Venkataramani AS, Nattrass N, Seekings J, Whiteside AW. A cut above the rest: traditional male circumcision and HIV risk among xhosa men in Cape Town, South Africa . J Acquir Immune Defic Syndr 2011; 58:499–505.
Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV prevention: a prospective study of complications in clinical and traditional settings in Bungoma, Kenya . Bull World Health Organ 2008; 86:669–677.
Wilcken A, Keil T, Dick B. Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications . Bull World Health Organ 2010; 88:907–914.
Shaffer DN, Bautista CT, Sateren WB, Sawe FK, Kiplangat SC, Miruka AO, et al. The protective effect of circumcision on HIV incidence in rural low-risk men circumcised predominantly by traditional circumcisers in Kenya: two-year follow-up of the Kericho HIV cohort study . J Acquir Immune Defic Syndr 2007; 45:371–379.
Weiss HA, Quigley MA, Hayes RJ. Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis . AIDS Lond Engl 2000; 14:2361–2370.
Jayathunge PHM, McBride WJH, MacLaren D, Kaldor J, Vallely A, Turville S. Male circumcision and HIV transmission; what do we know? . Open AIDS J 2014; 8:31–44.
Hayes RJ, Moulton LH. Cluster randomised trials . 2nd ed.New York: Chapman and Hall/CRC; 2017.
Connolly C, Simbayi LC, Shanmugam R, Nqeketo A. Male circumcision and its relationship to HIV infection in South Africa: results of a national survey in 2002 . South Afr Med J 2008; 98:789–794.
Maffioli EM. Is traditional male circumcision effective as an HIV prevention strategy? Evidence from Lesotho . PLoS One 2017; 12:e0177076.
Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HIV infection among men in Tanzania . AIDS Lond Engl 1997; 11:73–79.
Thomas AG, Tran BR, Cranston M, Brown MC, Kumar R, Tlelai M. Voluntary medical male circumcision: a cross-sectional study comparing circumcision self-report and physical examination findings in Lesotho . PLoS One 2011; 6:e27561.
Peltzer K, Nqeketo A, Petros G, Kanta X. Traditional circumcision during manhood initiation rituals in the Eastern Cape, South Africa: a prepost intervention evaluation . BMC Public Health 2008; 8:64.
2020 Global AIDS Update — Seizing the moment — Tackling entrenched inequalities to end epidemics. Available at https://www.unaids.org/en/resources/documents/2020/global-aids-report [Accessed 23 January 2023]
Peltzer K, Kanta X. Medical circumcision and manhood initiation rituals in the Eastern Cape, South Africa: a post intervention evaluation . Cult Health Sex 2009; 11:83–97.
Mark D, Middelkoop K, Black S, Roux S, Fleurs L, Wood R, et al. Low acceptability of medical male circumcision as an HIV/AIDS prevention intervention within a South African community that practises traditional circumcision . South Afr Med J 2012; 102:571–573.
Sgaier SK, Baer J, Rutz DC, Njeuhmeli E, Seifert-Ahanda K, Basinga P, et al. Toward a systematic approach to generating demand for voluntary medical male circumcision: insights and results from field studies . Glob Health Sci Pract 2015; 3:209–229.
Khumalo-Sakutukwa G, Lane T, van-Rooyen H, Chingono A, Humphries H, Timbe A, et al. Understanding and addressing socio-cultural barriers to medical male circumcision in traditionally non-circumcising rural communities in sub-Saharan Africa . Cult Health Sex 2013; 15:1095–1100.
Kahn JG, Marseille E, Auvert B. Cost-effectiveness of male circumcision for HIV prevention in a South African setting . PLoS Med 2006; 3:e517.
Njeuhmeli E, Forsythe S, Reed J, Opuni M, Bollinger L, Heard N, et al. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in Eastern and Southern Africa . PLoS Med 2011; 8:e1001132.
The DHS program – research topics – male circumcision. Available at: https://dhsprogram.com/topics/male-circumcision.cfm [Accessed 21 July 2021].