Male Circumcision for HIV Prevention in Men in Rakai, Uganda: a Randomised Trial

Replication paper
Original publication: Lancet
Original researchers: Ronald H. Gray, Godfrey Kigozi, David Serwadda, Frederick Makumbi, Stephen Watya, Fred Nalugoda, Noah Kiwanuka, Lawrence H. Moulton, Mohammad A. Chaudhary, Michael Z. Chen, Nelson K. Sewankambo, Fred Wabwire-Mangen, Melanie C. Bacon, Carolyn F.M. Williams, Pius Opendi, Steven J. Reynolds, Oliver Laeyendecker, Thomas C. Quinn, Maria J. Wawer
Replication researchers: Eric Djimeu

The Original Study

Numerous observational studies, mainly from sub-Saharan Africa, have showed that male circumcision reduces the risk of HIV acquisition in men. This study evaluates the effect of male circumcision on HIV incidence in men in Rakai, Uganda. Specifically, half of 4996 uncircumcised, HIV-negative men aged 15–49 years forming the sample of the study were randomly assigned to receive immediate circumcision or circumcision delayed for 24 months .In order to determine the impact of male circumcision after 24 months, the authors used a modified intention-to-treat approach for the primary effi cacy analysis, which included all participants who were serologically or polymerase chain reaction negative at enrolment. Also, in primary analyses, the authors adjusted incidence rate ratios of HIV acquisition for postulated potential confounders identified in previous studies in Rakai including baseline values of age, marital status, and sexual risk behaviours. Lastly, the authors assessed possible behavioural disinhibition.