on evidence in support of male circumcision in hiv prevention what next在艾滋病毒预防证据支持男性包皮环切下.pdfVIP

Correspondence Major Potential Confounder The Protective Effect of Male Not Addressed Circumcision as a Faith Lift for Jennifer Vines the Troubled Paradigm of HIV This is the fi rst of 12 Correspondence pieces in this issue that are in response to an important PLoS Medicine Research Article: Auvert B, Taljaard D, Epidemiology in Sub-Saharan Africa Lagarde E, Sobngwi-Tambekou J, Sitta R, et al. (2005) Randomized, John J. Potterat, Devon D. Brewer, Stephen Q. Muth, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med 2(11): e298. Readers Stuart Brody wishing to add their own views may do so using our E-letters facility, where Auvert and colleagues present preliminary evidence for the the debate continues. protective effect of male circumcision on HIV acquisition [1]. Their report also reveals several problems with the widely In the article by Auvert et al. regarding incidence rates of held assumption that penile–vaginal sex accounts for the HIV infection in circumcised versus uncircumcised men, the overwhelming majority of HIV transmission in sub-Saharan fi nding of 60% fewer infections among the former group Africa. is compelling [1]. I must echo the comments submitted We are baffl ed that the factor most strongly associated with by others and question these fi ndings in light of the fact incident HIV infection—attendance at “a clinic for a h