Association of Medical Male Circumcision and Antiretroviral Therapy Scale-up With Community HIV Incidence in Rakai,Uganda

Abstract
Randomized trials have shown that medical male circumcision( MMC)reduces maleHIVacquisition by50% to 60%,1-3 and that early initiation of antiretroviral therapy (ART) reduces HIV transmission by more than90%in HIV-discordant couples.4Mathematical modeling suggests that these interventions could mitigate the HIV epidemic in sub- Saharan Africa,5-7 but there is limited empirical evidence for the population-level effects of these interventions on HIV incidence in real-world programs. MMC provides direct protection against male HIV acquisition by removing the foreskin, which is rich in HIV target cells.8-10 The potential effect ofMMCon population-level HIV incidence depends on this biological effect, the level ofMMC coverage, risk profiles ofmenacceptingMMC,and whether behavioral disinhibition occurs following circumcision.
Description
Keywords
Medical Male Circumcision, Antiretroviral Therapy, Community
Citation
Kong, X., Kigozi, G., Ssekasanvu, J., Nalugoda, F., Nakigozi, G., Ndyanabo, A., ... & Gray, R. H. (2016). Association of medical male circumcision and antiretroviral therapy scale-up with community HIV incidence in Rakai, Uganda. Jama, 316(2), 182-190. doi:10.1001/jama.2016.7292