Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial

Gray, Ronald H.; Kigozi, Godfrey; Serwadda, David; Makumbi, Frederick; Watya, Stephen; Nalugoda, Fred; Kiwanuka, Noah; Moulton, Lawrence H.; Chaudhary, Mohammad A.; Chen, Michael Z.; Sewankambo, Nelson; Wâbwire-Mângen, Fred; Bacon, Melanie C.; Williams, Carolyn; Opendi, Pius; Reynolds, Steven J.; Laeyendecker, Oliver; Quinn, Thomas C.; Wawer, Maria J.

doi:10.1016/s0140-6736(07)60313-4

Cited by 1,934 publications

(1,690 citation statements)

References 22 publications

Supporting

Mentioning

1,606

Contrasting

Unclassified

Order By: Relevance

“…Of these ten articles, collectively cited 6132 times, three (Black et al 2008;Daemen et al 2007;Goldberg et al 2008) were identified as non-RCT publications, and excluded. From the remaining seven, two each dealing with HIV-AIDS (Gray et al 2007;Bailey et al 2007) and renal cell carcinoma (Escudier et al 2007;Motzer et al 2008), and one each on HPV vaccination (Paavonen et al 2007), vascular outcomes in diabetes (Patel et al 2007), and breast cancer (Smith et al 2007), a total of 35 intervention or outcome measures were identified (see table 1, supplementary material). The age was estimated as per the methods discussed in the supplementary material.…”

Section: Assessing Rctsmentioning

confidence: 99%

“…For example, Bailey (et al 2007) specified the use of a circumcision technique dating from 2005 (Krieger et al 2005). Where no technique was specified, as in the case of Gray (et al 2007), the date at which that particular procedure might usefully be employed in the specified context was employed. In this case, the date was given as 1986, being the first suggestion that circumcision might be a means of preventing HIV transmission (Alcena 1986;Fink 1986).…”

Section: Supplementary Materialsmentioning

confidence: 99%

See 1 more Smart Citation

The evidence that evidence-based medicine omits

Clarke

Gillies

Illari

et al. 2013

Preventive Medicine

View full text Add to dashboard Cite

According to current hierarchies of evidence for EBM, evidence of correlation (e.g., from RCTs) is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a causal claim. Second, evidence of mechanisms is often required in order to obtain evidence of correlation (for example, in order to set up and evaluate RCTs). Third, evidence of mechanisms is often required in order to generalise and apply causal claims.While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms.

show abstract

Section: Assessing Rctsmentioning

confidence: 99%

Section: Supplementary Materialsmentioning

confidence: 99%

The evidence that evidence-based medicine omits

Clarke

Gillies

Illari

et al. 2013

Preventive Medicine

View full text Add to dashboard Cite

show abstract

“…1 Circumcision is generally considered as a simple, rapid operation with efficacy for protection against HIV and other sexually transmitted infections, as confirmed in numerous, highquality studies. [2][3][4][5][6][7] Circumcision has been reported to adversely affect sexual function; 8 however, the majority of studies, including highquality ones [9][10][11] and ones with data arising from randomized controlled trials (RCTs), 12,13 show no difference or improvement in sexual function, sensitivity and satisfaction after circumcision. All of the data were considered by the American Academy of Pediatrics in formulating its 2012 policy, which concluded that there were no adverse effects on these parameters.…”

Section: Introductionmentioning

confidence: 99%

Effects of circumcision on male sexual functions: a systematic review and meta-analysis

Liu¹,

Wang²,

Wazir³

et al. 2013

Asian J Androl

View full text Add to dashboard Cite

This meta-analysis was performed to assess sexual functions following adult male circumcision. We searched the Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, the Cochrane Database of Systematic Review and Web of Science from their inception until January 2013 to identify all eligible studies that reported on men's sexual function after circumcision. The Cochrane Collaboration's RevMan 5.2 software was employed for data analysis, and the fixed or the random effect model was selected depending on the proportion of heterogeneity. We identified 10 studies, which described a total of 9317 circumcised and 9423 uncircumcised men who were evaluated for the association of circumcision with male sexual function. There were no significant differences in sexual desire (odds ratio (OR): 0.99; 95% confidence interval (CI): 0.92-1.06), dyspareunia (OR: 1.12; 95% CI: 0.52-2.44), premature ejaculation (OR: 1.13; 95% CI: 0.83-1.54), ejaculation latency time (OR: 1.33; 95% CI: 0.69-1.97), erectile dysfunctions (OR: 0.90; 95% CI: 0.65-1.25) and orgasm difficulties (OR: 0.97; 95% CI: 0.83-1.13). These findings suggest that circumcision is unlikely to adversely affect male sexual functions. However, these results should be evaluated in light of the low quality of the existing evidence and the significant heterogeneity across the various studies. Well-designed and prospective studies are required for a further understanding of this topic.

show abstract

“…More than 30 years into the HIV/AIDS epidemic, an effective HIV vaccine remains an elusive public health goal. Despite important discoveries about the effectiveness of prevention interventions, such as male circumcision 32,33 and the use of antiretroviral drugs such as microbicides, 34 prophylactic therapy for HIV-uninfected individuals, 35,36 or life-long suppressive therapy for infected individuals, 37 an effective vaccine able to confer long-term immunity is still considered a necessity if we are to eventually end the global AIDS pandemic. 38 Our objectives with this research were to investigate (1) whether trust in research and HIV conspiracy beliefs differed by racial/ ethnic group among community-recruited individuals in a large metropolitan area in the Midwest, and (2) whether trust in research and HIV conspiracy beliefs were associated with willingness to participate in HIV vaccine trials.…”

Section: Introductionmentioning

confidence: 99%