Does Male Circumcision Prevent HIV Infection 英文参考文献.docVIP

Open access, freely available online Perspectives Does Male Circumcision Prevent HIV Infection? Nandi Siegfried G iven the devastating mortality and morbidity associated with HIV/AIDS, many potential with HIV during the trial compared with 49 men in the control group. The risk of acquiring HIV infection was signi?cantly reduced by 60% in the men who had undergone circumcision (incidence rate ratio = 0.4; p 0.001). All men in the control group were then offered circumcision. box, this was not necessarily the case with the participant box. This unequal distribution partly explains why the numbers in the comparison groups differ by a total of 40. Perhaps of more concern is that allocation concealment may have been inadequate given that the centre manager was responsible for ?lling both boxes of envelopes, and potentially could have subverted the treatment allocation, thus introducing selection bias. Inadequate allocation concealment has been shown to be associated with exaggerated treatment effects [10,11]. Despite this, as the baseline characteristics of both comparison groups are similar and the sensitivity analyses of the results are robust, the effect of these quality parameters is probably negligible. prevention measures against HIV infection have been explored. Male circumcision is one of these, and seven reviews of the literature [1–7], including two meta-analyses [4,5], have been published. However, as pointed out in the Cochrane systematic review of the subject, all studies to date were observational, and many were of poor quality. In the absence of any experimental evidence, no causal relationship between male circumcision and HIV prevention could be con?dently assumed [7]. Strengths of the Study One strength of this study is that participants were drawn from the general population, increasing the generalisability of the ?ndings. In addition, the relatively low loss to follow-up (7.9% overall) demonstrates that trials of this nature can be adequately c