3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

IMPACT OF MALE CIRCUMCISION ON THE FEMALE-TO-MALE TRANSMISSION OF HIV

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuOa0402

Auvert B.¹, Puren A.², Taljaard D.³, Lagarde E.⁴, Sitta R.⁴, Tambekou J.^4
1UVSQ - INSERM U687 - APHP, ST Maurice CEDEX, France, ²NICD, Johannesburg, South Africa, ³Progressus CC, Johannesburg, South Africa, ⁴INSERM U687, St Maurice, France

INTRODUCTION: Observational studies suggest that male circumcision could protect against HIV-1 acquisition. A randomized control intervention trial to test this hypothesis was performed in sub-Saharan Africa with a high prevalence of HIV and where the mode of transmission is through sexual contact.

METHODS: 3273 uncircumcised men, aged 18-24 and wishing to be circumcised, were randomized in a control and intervention group. Men were followed for 21 months with an inclusion visit and follow-up visits at month 3, 12 and 21. Male circumcision was offered to the intervention group just after randomization and to the control group at the end of 21 month follow-up visit. Male circumcisions were performed by medical doctors. At each visit, sexual behavior was assessed by a questionnaire and a blood sample was taken for HIV serology. These grouped censored data were analyzed in an “intention to prevent” univariate and multivariate analysis using the piecewise survival model, and relative risk (RR) of HIV infection with 95% confidence interval (95% CI) was determined.

RESULTS: Loss to follow-up was <11%; <1% of the intervention group were not circumcised and < 2% of the control group were circumcised during the follow-up. We observed 45 HIV infections in the control group and 15 in the intervention group, RR=2.77 (95% CI: 1.56 – 4.91; p=0.0005). When controlling for sexual behavior, including condom use and health seeking behavior, the RR was unchanged: RR=2.93 (p=0.0003).

CONCLUSIONS: Male circumcision provides a high degree of protection against HIV infection acquisition. Male circumcision is equivalent to a vaccine with a 63% efficacy. The promotion of male circumcision in uncircumcised males will reduce HIV incidence among men and indirectly will protect females and children from HIV infection. Male circumcision must be recognized as an important means to fight the spread of HIV infection and the international community must mobilize to promote it.

Download PDF of this abstract.

050724
Prevention | TuOa0402 | Bertran Auvert
Sexual transmission

Copyright © 2005 - International AIDS Society (IAS). All information and content relating to the abstracts from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.