Association of Medical Male Circumcision and Antiretroviral Therapy Scale-up With Community HIV Incidence in Rakai,Uganda
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
American Medical Association
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