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(late-HAART) were established. SIR evaluates a measure of risk related to the general population, and is defined as the ratio of observed to expected number of cancers. Expected counts were estimated by applying gender, age, and calendar years PRCCR's specific cancer incidence rates to our cohort. Results Of the 296 malignancies found; 29.3% were women, 39.3% were injecting drug users and 42.9% were AIDS related cancers. The SIR for all malignancies in the pre-HAART period (10.15) decreased to 5.35 in the early-HAART, and to 2.04 in the late-HAART period. AIDS related malignancies SIRs decreased after HAART from 91.99 to 16.48; however, Kaposi's sarcoma (KS) and invasive cervical carcinoma (ICC) SIRs remained significantly higher in the late-HAART period (50.52 and 9.17). Non-AIDS related malignancies' SIRs of the oral cavity/pharynx, liver, anus, vaginal, testis, Hodgkin's lymphomas (HL) and non-HL (NHL) were significantly higher (SIRs > 3.30) in the late-HAART period. Conclusion Availability of HAART in this Hispanic HIV/AIDS cohort has significantly decreased the malignancies risk. However, the higher incidence of KS, ICC and non-AIDS related malignancies in the late-HAART is suggestive of the role of additional oncogenic factors including sexual transmitted and injecting drug use infections. Aggressive intervention in the form of vaccines, risky practise reduction, early screening intervention and education needs to be incremented in this vulnerable population. Granted by 8G12MD007583, 8U54MD007587 and NPCR-CDC

infection at baseline. Efficacy data were synthesised using a DerSimonian and Laird weighted random-effect model. The mean odds ratio (OR) and 95% confidence interval (CI) for the association between Cervarix™, Gardasil ® and HPV-16 monovalent vaccine and HPV-associated cervical intraepithelial neoplasia grade 3 or worse (CIN3+) was 0·90 (CI: 0·56, 1·44) and for the association between Gardasil ® and HPV-associated vulval/vaginal intraepithelial neoplasia grades 2-3 (VIN2-3/VaIN2-3) OR 1·20 (CI: 0·07, 20·40). Conclusion There was no evidence that the HPV vaccines are effective in preventing vaccine-type HPV-associated pre-cancer in women with evidence of prior HPV exposure in this analysis. However, these studies were not designed to investigate the efficacy in this group, so statistical power (sample size, follow-up period and event rate) was insufficient to detect a small effect size. Longer follow-up is also needed to detect possible prevention of re-infection. Background Zimbabwe has a target to reach 80% voluntary medical male circumcision (VMMC) coverage among HIV-negative 15-29 year-old men by 2015. This is a central strategy in the nation's HIV response. Despite considerable recent investment, uptake has been slower than hoped. A cluster-randomised trial began in 2012 to assess the effectiveness of a sport-based VMMC demand-creation intervention. Methods At baseline, 663 men aged 18-45 years (median age 24 years) on 47 local soccer teams (both social and professional) in Bulawayo completed a self-administered questionnaire on VMMCrelated knowledge, perceptions and intent using touchscreen mobile phones. Linear and logistic regressions were used to assess differences by age, educational attainment, and study group, adjusting for team-level clustering. Results 141 men (21.0%) reported being circumcised, the majority (80.6%) at a hospital or clinic and 24 (17.0%) within the last three months. Among the uncircumcised men, the majority (90.8%) knew that VMMC reduces HIV risk and thought that getting circumcised was a good idea (89.3%). About half (54.2%) correctly identified at least one local clinic providing VMMC services and 62.6% reported that they were planning to get circumcised. Among uncircumcised men, those with A-level/higher education had better VMMC knowledge (AOR = 3.15, 95% CI = 1.52-6.53), but were less likely to intend to become circumcised (AOR = 0.57, 95% CI = 0.37-0.89). Being circumcised was weakly associated with having A-Level/higher education (AOR = 1.52, 95% CI = 0.95-2.43). No differences were observed between study groups in reported circumcision status, age, education, VMMC knowledge, or VMMC intention. Conclusion This study provides evidence that VMMC-related knowledge and intentions are high amongst uncircumcised, soccerplaying men in Bulawayo, though VMMC coverage remains far below 80%. Effective demand creation interventions are needed and should ensure uncircumcised men are aware of local sites offering VMMC services. Further research should investigate barriers to VMMC uptake ...

The International Initiative for Impact Evaluation (3ie) is an international grant-making NGO promoting evidence-informed development policies and programmes. We are the global leader in funding, producing and synthesising high-quality evidence of what works, how, why and at what cost. We believe that better and policy-relevant evidence will make development more effective and improve people's lives. 3ie impact evaluations3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design, use the most appropriate mix of methods to capture outcomes and are useful in complex development contexts. About this report3ie accepted the final version of this report, Voluntary medical male circumcision uptake through soccer in Zimbabwe, in November 2015 as partial fulfilment of requirements under grant TW3.09, issued under Thematic Window 3. The content has been copy edited and formatted for publication by 3ie. All of the content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors or its Board of Commissioners. Any errors and omissions are also the sole responsibility of the authors. Authors' affiliations listed in the title page are those that were in effect at the time the report was accepted. Any comments or queries should be directed to corresponding author Jeff DeCelles at j.decelles@grassrootsoccer.org. SummaryMake The Cut Plus (MTC+) is a short, sport-based intervention, delivered by Grassroot Soccer, that aims to increase demand for male circumcision among adolescent male students (aged 15 to 19 years) in secondary schools in Bulawayo, Zimbabwe. MTC+ consists of a 60-minute soccer-themed educational session led by a trained 'coach', who was circumcised; information, education, and communication material on male circumcision; referrals and phone-based follow-up to interested participants conducted by the coaches; and soccer-based incentives to participants who completed VMMC. This study's objective was to determine if the MTC+ intervention could substantially and significantly increase demand for VMMC in secondary schools and whether the intervention is an effective, innovative and scalable solution to increasing uptake of VMMC. The study was constructed as a cluster-randomised trial to assess the effectiveness of MTC+. Twenty-six schools in Bulawayo were randomised to receive MTC+ at the start of a four-month trial (intervention) or at the end (control). VMMC uptake over four months was measured via cross-linkage of the trial participant database (n=1,226 male participants aged 14 to 20 years; median age 16.2) and clinic registers of Bulawayo's two free VMMC clinics (n=5,713) from 7 March to 6 July 2014, using eight identifying variables. The trial had more than 80 per cent power to detect an absolute difference of 5 percentage points in VMMC uptake.A process evaluation was conducted to explore perceptions of VMMC, perceptions and...