Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial

Bailey, Robert C.; Moses, Stephen; Parker, Corette B.; Agot, Kawango; Maclean, Ian; Krieger, John N.; Williams, Carolyn; Campbell, Richard T.; Ndinya‐Achola, Jeckoniah

doi:10.1016/s0140-6736(07)60312-2

Cited by 1,955 publications

(1,385 citation statements)

References 34 publications

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“…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%

“…Where a precise technique was specified in print, then the publication date of the resource referred to as descriptive of that procedure was used. 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.…”

Section: Supplementary Materialsmentioning

confidence: 99%

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The evidence that evidence-based medicine omits

Clarke

Gillies

Illari

et al. 2013

Preventive Medicine

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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.

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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

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“…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

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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.

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“…Detailed findings from the Uganda and Kenya trials were published in the Lancet in February 2007, 12,13 reporting adjusted efficacy findings on an intention-to-treat analysis of 51% (Uganda) and 53% (Kenya), with modified analyses taking into account particularities of sampling and field procedures yielding figures of 55% and 60% efficacy respectively. * These findings were published just before a major international consultation on Male Circumcision and HIV Prevention: Research Implications for Policy and Programming was convened by the World Health Organization (WHO) and UNAIDS in Montreux, Switzerland, 6-8 March 2007. y The meeting formulated draft recommendations to the world from WHO/UNAIDS and the rest of the UN system on adopting male circumcision as one additional approach to enhancing prevention efforts in high HIV prevalence, generalised epidemics where HIV transmission between women and men is the major route of infection.…”

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confidence: 99%