| Autor: |
Gao, Yanxiao, Zhan, Yuewei, Sun, Yinghui, Zheng, Weiran, Zhang, Weijie, Fu, Leiwen, Guo, Zhihui, Lin, Yi-Fan, Li, Yuwei, Zheng, Lingling, Zhan, Yiqiang, Zhu, Zhiqiang, Duan, Junyi, Zhang, Guanghui, Huang, Tao, Su, Bin, Yu, Maohe, Wu, Guohui, Ouyang, Lin, Zhao, Jin |
| Předmět: |
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| Zdroj: |
Annals of Internal Medicine; Jun2024, Vol. 177 Issue 6, p719-728, 11p |
| Abstrakt: |
Men who have sex with men (MSM) have high incidence rates of HIV infection worldwide. Voluntary medical male circumcision (VMMC) reduces HIV risk for men who have sex with women, but whether it is an effective strategy for MSM remains uncertain. This randomized controlled trial assessed the efficacy of VMMC in preventing incident HIV infection among MSM in China at a time when preexposure prophylaxis was not routinely offered or used. Visual Abstract. Efficacy of Voluntary Medical Male Circumcision to Prevent HIV Infection Among Men Who Have Sex With Men: Men who have sex with men (MSM) have high incidence rates of HIV infection worldwide. Voluntary medical male circumcision (VMMC) reduces HIV risk for men who have sex with women, but whether it is an effective strategy for MSM remains uncertain. This randomized controlled trial assessed the efficacy of VMMC in preventing incident HIV infection among MSM in China at a time when preexposure prophylaxis was not routinely offered or used. Background: Observational studies suggest that voluntary medical male circumcision (VMMC) may lower HIV risk among men who have sex with men (MSM). A randomized controlled trial (RCT) is needed to confirm this. Objective: To assess the efficacy of VMMC in preventing incident HIV infection among MSM. Design: An RCT with up to 12 months of follow-up. (Chinese Clinical Trial Registry: ChiCTR2000039436) Setting: 8 cities in China. Participants: Uncircumcised, HIV-seronegative men aged 18 to 49 years who self-reported predominantly practicing insertive anal intercourse and had 2 or more male sex partners in the past 6 months. Intervention: VMMC. Measurements: Rapid testing for HIV was done at baseline and at 3, 6, 9, and 12 months. Behavioral questionnaires and other tests for sexually transmitted infections were done at baseline, 6 months, and 12 months. The primary outcome was HIV seroconversion using an intention-to-treat analysis. Results: The study enrolled 124 men in the intervention group and 123 in the control group, who contributed 120.7 and 123.1 person-years of observation, respectively. There were 0 seroconversions in the intervention group (0 infections [95% CI, 0.0 to 3.1 infections] per 100 person-years) and 5 seroconversions in the control group (4.1 infections [CI, 1.3 to 9.5 infections] per 100 person-years). The HIV hazard ratio was 0.09 (CI, 0.00 to 0.81; P = 0.029), and the HIV incidence was lower in the intervention group (log-rank P = 0.025). The incidence rates of syphilis, herpes simplex virus type 2, and penile human papillomavirus were not statistically significantly different between the 2 groups. There was no evidence of HIV risk compensation. Limitation: Few HIV seroconversions and limited follow-up period. Conclusion: Among MSM who predominantly practice insertive anal intercourse, VMMC is efficacious in preventing incident HIV infection; MSM should be included in VMMC guidelines. Primary Funding Source: The National Science and Technology Major Project of China. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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