The Original Study
In the past two decades, numerous observational studies have shown a signficant protective effect of male circumcision against acquisition of HIV. This relation is confirmed by ecological studies which show that in most countries in sub-Saharan Africa, there is an inverse relation between the HIV prevalence and male circumcision. This study evaluates whether male circumcision has an impact on HIV incidence in young men in Kisumu, Kenya. Specifically, almost half of 2784 uncircumcised, HIV negative men aged 18–24 years were randomly assigned to the intervention group (circumcision) and the other half in the control group (delayed circumcision for 24 months). The authors used the intent to treat analysis to determine the impact of male circumcision during follow-ups at 1, 3, 6, 12, 18, and 24 months. Furthermore, fixed covariates and variables that seemed to be slightly imbalanced at baseline were used in adjusted models. Lastly, the authors assessed changes in sexual behavior related to this intervention.
The Replication
There is an urgent and continuing need to identify cost-effective and practical interventions to prevent HIV transmission. Three recent studies have found that male circumcision can significantly reduce HIV incidence in men. These results opened an enormous potential intervention for HIV prevention in African countries. We propose to replicate one of the studies conducted in Kisumu, Kenya, to shed additional light on the relationship between circumcision status and HIV infection, and influence the policy trajectory. We will use the raw data and replicate methods used to produce the results presented in the published report, as well as employing methodologic modifications to include additional epidemiologic approaches and econometric approaches.