Replication of ‘Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: a randomized trial in Rakai, Uganda’

Replication Researchers: Fang Yu
Title: Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV_negative women: a randomized trial in Rakai, Uganda
Original Researchers: Maria J. Wawer, Aaron A.R. Tobian, Godfrey Kigozi, Xiangrong Kong, Patti E. Gravitt, David Serwadda, Fred Nalugoda, Frederick Makumbi, Victor Ssempiija, Nelson Sewankambo, Stephen Watya, Kevin P. Eaton, Amy E. Oliver, Michael Z. Chen, Steven J. Reynolds, Thomas C. Quinn, Ronald H. Gray
Original publicationLancet 
Replication Plan: Not Applicable 
Current Status: Unable to Replicate

The Original Study

The study examines the impact of a cash transfer programme on the prevalence of human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV-2). The study also assesses the programme’s impacts on syphilis prevalence, school enrolment, self-reported marriage, pregnancy and sexual behaviour. The authors designed and implemented an intervention in 176 enumeration areas in Zomba district in Malawi between January 2008 and December 2009.The study population consisted of all never-married girls aged 13 to 22 years. After completion of the baseline surveys, 88 enumeration areas were randomly assigned to the intervention group and the other 88 to the control group. In the intervention group, conditional and unconditional cash transfers were given to guardians of the girls and directly to the girls. In the conditional group, cash transfers were given after the girls had attended school regularly during the previous month. Data were collected from 3,796 individuals. The study found that both the conditional and unconditional cash transfer interventions significantly reduced the prevalence of HIV and HSV-2. 18 months after the baseline surveys, in the cohort of baseline school girls, weighted HIV prevalence was found to be 1.2 per cent in the intervention group and 3.0 per cent in the control group. Weighted HSV-2 prevalence was 0.7 per cent in the intervention group and 3.0 per cent in the control group. The study found that there is no significant difference between conditional and unconditional intervention groups, regarding HIV and HSV-2 prevalence. Overall, this study shows that cash transfers to unmarried school girls can help reduce risky sexual activities and the likelihood that young women will be infected with HIV and HSV-2. Further studies are needed to examine whether this intervention works in other settings.

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