Loevinsohn, G., Kigozi, G., Kagaayi, J., Wawer, M. J., Nalugoda, F., Chang, L. W., Quinn, T. C., Serwadda, D., Reynolds, S. J., Nelson, L., Mills, L., Alamo, S., Nakigozi, G., Kabuye, G., Ssekubugu, R., Tobian, A. A. R., Gray, R. H., Grabowski, M. K., Nabukalu, D., ... Laeyendecker, O. (2021). Effectiveness of Voluntary Medical Male Circumcision for Human Immunodeficiency Virus Prevention in Rakai, Uganda. Clinical Infectious Diseases, 73(7), E1946-E1953. https://doi.org/10.1093/cid/ciaa1533
Loevinsohn, G, Kigozi, G, Kagaayi, J, Wawer, MJ, Nalugoda, F, Chang, LW, Quinn, TC, Serwadda, D, Reynolds, SJ, Nelson, L, Mills, L, Alamo, S, Nakigozi, G, Kabuye, G, Ssekubugu, R, Tobian, AAR, Gray, RH, Grabowski, MK, Nabukalu, D, Ndyanabo, A, Ssekasanvu, J, Nakawooya, H, Nakukumba, J, Kigozi, GN, Nantume, BS, Resty, N, Kambasu, J, Nalugemwa, M, Nakabuye, R, Ssebanobe, L, Nankinga, J, Kayiira, A, Nanfuka, G, Ahimbisibwe, R, Tomusange, S, Galiwango, RM, Kalibbali, S, Nakalanzi, M, Otobi, JO, Ankunda, D, Ssembatya, JL, Ssemanda, JB, Kairania, R, Kato, E, Kisakye, A, Batte, J, Ludigo, J, Nampijja, A, Watya, S, Nehemia, K, Anyokot, SM, Mwinike, J, Kibumba, G, Ssebowa, P, Mondo, G, Wasswa, F, Nantongo, A, Kakembo, R, Galiwango, J, Ssemango, G, Redd, AD, Santelli, J, Kennedy, CE, Wagman, J, Lutalo, T, Makumbi, F, Sewankambo, NK & Laeyendecker, O 2021, 'Effectiveness of Voluntary Medical Male Circumcision for Human Immunodeficiency Virus Prevention in Rakai, Uganda', Clinical Infectious Diseases, vol. 73, n.º 7, pp. E1946-E1953. https://doi.org/10.1093/cid/ciaa1533
@article{3c0283d6092a4b7e8765fd1c1975dfea,
title = "Effectiveness of Voluntary Medical Male Circumcision for Human Immunodeficiency Virus Prevention in Rakai, Uganda",
abstract = "Background: The efficacy of voluntary male medical circumcision (VMMC) for human immunodeficiency virus (HIV) prevention in men was demonstrated in 3 randomized trials. This led to the adoption of VMMC as an integral component of the United States President's Emergency Plan for AIDS Relief (PEPFAR) combination HIV prevention program in sub-Saharan Africa. However, evidence on the individual-level effectiveness of VMMC programs in real-world, programmatic settings is limited. Methods: A cohort of initially uncircumcised, non-Muslim, HIV-uninfected men in the Rakai Community Cohort Study in Uganda was followed between 2009 and 2016 during VMMC scale-up. Self-reported VMMC status was collected and HIV tests performed at surveys conducted every 18 months. Multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) of HIV acquisition in newly circumcised vs uncircumcised men. Results: A total of 3916 non-Muslim men were followed for 17 088 person-years (PY). There were 1338 newly reported VMMCs (9.8/100 PY). Over the study period, the median age of men adopting VMMC declined from 28 years (interquartile range [IQR], 21-35 years) to 22 years (IQR, 18-29 years) (P for trend <. 001). HIV incidence was 0.40/100 PY (20/4992.8 PY) among newly circumcised men and 0.98/100 PY (118/12 095.1 PY) among uncircumcised men with an adjusted IRR of 0.47 (95% confidence interval,. 28-.78). The effectiveness of VMMC was sustained with increasing time from surgery and was similar across age groups and calendar time. Conclusions: VMMC programs are highly effective in preventing HIV acquisition in men. The observed effectiveness is consistent with efficacy in clinical trials and supports current recommendations that VMMC is a key component of programs to reduce HIV incidence.",
author = "Gideon Loevinsohn and Godfrey Kigozi and Joseph Kagaayi and Wawer, {Maria J.} and Fred Nalugoda and Chang, {Larry W.} and Quinn, {Thomas C.} and David Serwadda and Reynolds, {Steven J.} and Lisa Nelson and Lisa Mills and Stella Alamo and Gertrude Nakigozi and Geoffrey Kabuye and Robert Ssekubugu and Tobian, {Aaron A.R.} and Gray, {Ronald H.} and Grabowski, {M. Kathryn} and Dorean Nabukalu and Anthony Ndyanabo and Joseph Ssekasanvu and Hadijja Nakawooya and Jessica Nakukumba and Kigozi, {Grace N.} and Nantume, {Betty S.} and Nampijja Resty and Jedidah Kambasu and Margaret Nalugemwa and Regina Nakabuye and Lawrence Ssebanobe and Justine Nankinga and Adrian Kayiira and Gorreth Nanfuka and Ruth Ahimbisibwe and Stephen Tomusange and Galiwango, {Ronald M.} and Sarah Kalibbali and Margaret Nakalanzi and Otobi, {Joseph Ouma} and Denis Ankunda and Ssembatya, {Joseph Lister} and Ssemanda, {John Baptist} and Robert Kairania and Emmanuel Kato and Alice Kisakye and James Batte and James Ludigo and Abisagi Nampijja and Steven Watya and Kighoma Nehemia and Anyokot, {Sr Margaret} and Joshua Mwinike and George Kibumba and Paschal Ssebowa and George Mondo and Francis Wasswa and Agnes Nantongo and Rebecca Kakembo and Josephine Galiwango and Geoffrey Ssemango and Redd, {Andrew D.} and John Santelli and Kennedy, {Caitlin E.} and Jennifer Wagman and Tom Lutalo and Fred Makumbi and Sewankambo, {Nelson K.} and Oliver Laeyendecker",
note = "Publisher Copyright: {\textcopyright} 2020 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.",
year = "2021",
month = oct,
day = "1",
doi = "10.1093/cid/ciaa1533",
language = "English",
volume = "73",
pages = "E1946--E1953",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "7",
}
TY - JOUR
T1 - Effectiveness of Voluntary Medical Male Circumcision for Human Immunodeficiency Virus Prevention in Rakai, Uganda
AU - Loevinsohn, Gideon
AU - Kigozi, Godfrey
AU - Kagaayi, Joseph
AU - Wawer, Maria J.
AU - Nalugoda, Fred
AU - Chang, Larry W.
AU - Quinn, Thomas C.
AU - Serwadda, David
AU - Reynolds, Steven J.
AU - Nelson, Lisa
AU - Mills, Lisa
AU - Alamo, Stella
AU - Nakigozi, Gertrude
AU - Kabuye, Geoffrey
AU - Ssekubugu, Robert
AU - Tobian, Aaron A.R.
AU - Gray, Ronald H.
AU - Grabowski, M. Kathryn
AU - Nabukalu, Dorean
AU - Ndyanabo, Anthony
AU - Ssekasanvu, Joseph
AU - Nakawooya, Hadijja
AU - Nakukumba, Jessica
AU - Kigozi, Grace N.
AU - Nantume, Betty S.
AU - Resty, Nampijja
AU - Kambasu, Jedidah
AU - Nalugemwa, Margaret
AU - Nakabuye, Regina
AU - Ssebanobe, Lawrence
AU - Nankinga, Justine
AU - Kayiira, Adrian
AU - Nanfuka, Gorreth
AU - Ahimbisibwe, Ruth
AU - Tomusange, Stephen
AU - Galiwango, Ronald M.
AU - Kalibbali, Sarah
AU - Nakalanzi, Margaret
AU - Otobi, Joseph Ouma
AU - Ankunda, Denis
AU - Ssembatya, Joseph Lister
AU - Ssemanda, John Baptist
AU - Kairania, Robert
AU - Kato, Emmanuel
AU - Kisakye, Alice
AU - Batte, James
AU - Ludigo, James
AU - Nampijja, Abisagi
AU - Watya, Steven
AU - Nehemia, Kighoma
AU - Anyokot, Sr Margaret
AU - Mwinike, Joshua
AU - Kibumba, George
AU - Ssebowa, Paschal
AU - Mondo, George
AU - Wasswa, Francis
AU - Nantongo, Agnes
AU - Kakembo, Rebecca
AU - Galiwango, Josephine
AU - Ssemango, Geoffrey
AU - Redd, Andrew D.
AU - Santelli, John
AU - Kennedy, Caitlin E.
AU - Wagman, Jennifer
AU - Lutalo, Tom
AU - Makumbi, Fred
AU - Sewankambo, Nelson K.
AU - Laeyendecker, Oliver
N1 - Publisher Copyright:
© 2020 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: The efficacy of voluntary male medical circumcision (VMMC) for human immunodeficiency virus (HIV) prevention in men was demonstrated in 3 randomized trials. This led to the adoption of VMMC as an integral component of the United States President's Emergency Plan for AIDS Relief (PEPFAR) combination HIV prevention program in sub-Saharan Africa. However, evidence on the individual-level effectiveness of VMMC programs in real-world, programmatic settings is limited. Methods: A cohort of initially uncircumcised, non-Muslim, HIV-uninfected men in the Rakai Community Cohort Study in Uganda was followed between 2009 and 2016 during VMMC scale-up. Self-reported VMMC status was collected and HIV tests performed at surveys conducted every 18 months. Multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) of HIV acquisition in newly circumcised vs uncircumcised men. Results: A total of 3916 non-Muslim men were followed for 17 088 person-years (PY). There were 1338 newly reported VMMCs (9.8/100 PY). Over the study period, the median age of men adopting VMMC declined from 28 years (interquartile range [IQR], 21-35 years) to 22 years (IQR, 18-29 years) (P for trend <. 001). HIV incidence was 0.40/100 PY (20/4992.8 PY) among newly circumcised men and 0.98/100 PY (118/12 095.1 PY) among uncircumcised men with an adjusted IRR of 0.47 (95% confidence interval,. 28-.78). The effectiveness of VMMC was sustained with increasing time from surgery and was similar across age groups and calendar time. Conclusions: VMMC programs are highly effective in preventing HIV acquisition in men. The observed effectiveness is consistent with efficacy in clinical trials and supports current recommendations that VMMC is a key component of programs to reduce HIV incidence.
AB - Background: The efficacy of voluntary male medical circumcision (VMMC) for human immunodeficiency virus (HIV) prevention in men was demonstrated in 3 randomized trials. This led to the adoption of VMMC as an integral component of the United States President's Emergency Plan for AIDS Relief (PEPFAR) combination HIV prevention program in sub-Saharan Africa. However, evidence on the individual-level effectiveness of VMMC programs in real-world, programmatic settings is limited. Methods: A cohort of initially uncircumcised, non-Muslim, HIV-uninfected men in the Rakai Community Cohort Study in Uganda was followed between 2009 and 2016 during VMMC scale-up. Self-reported VMMC status was collected and HIV tests performed at surveys conducted every 18 months. Multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) of HIV acquisition in newly circumcised vs uncircumcised men. Results: A total of 3916 non-Muslim men were followed for 17 088 person-years (PY). There were 1338 newly reported VMMCs (9.8/100 PY). Over the study period, the median age of men adopting VMMC declined from 28 years (interquartile range [IQR], 21-35 years) to 22 years (IQR, 18-29 years) (P for trend <. 001). HIV incidence was 0.40/100 PY (20/4992.8 PY) among newly circumcised men and 0.98/100 PY (118/12 095.1 PY) among uncircumcised men with an adjusted IRR of 0.47 (95% confidence interval,. 28-.78). The effectiveness of VMMC was sustained with increasing time from surgery and was similar across age groups and calendar time. Conclusions: VMMC programs are highly effective in preventing HIV acquisition in men. The observed effectiveness is consistent with efficacy in clinical trials and supports current recommendations that VMMC is a key component of programs to reduce HIV incidence.
UR - http://www.scopus.com/inward/record.url?scp=85114464821&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85114464821&partnerID=8YFLogxK
U2 - 10.1093/cid/ciaa1533
DO - 10.1093/cid/ciaa1533
M3 - Article
C2 - 33043978
AN - SCOPUS:85114464821
SN - 1058-4838
VL - 73
SP - E1946-E1953
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 7
ER -
