Effectiveness of Voluntary Medical Male Circumcision for Human Immunodeficiency Virus Prevention in Rakai, Uganda

The efficacy of voluntary male medical circumcision (VMMC) for human immunodeficiency virus (HIV) prevention in men was demonstrated in 3 randomized trials. This led to the adoption of VMMC as an integral component of the United States President’s Emergency Plan for AIDS Relief (PEPFAR) combination HIV prevention program in sub-Saharan Africa. However, evidence on the individual-level effectiveness of VMMC programs in real-world, programmatic settings is limited. A cohort of initially uncircumcised, non-Muslim, HIV-uninfected men in the Rakai Community Cohort Study in Uganda was followed between 2009 and 2016 during VMMC scale-up. Self-reported VMMC status was collected and HIV tests performed at surveys conducted every 18 months. Multivariable Poisson regression was used to estimate the incidence rate ratio (IRR) of HIV acquisition in newly circumcised vs uncircumcised men.

Keywords

Circumcision, VMMC, Combination HIV prevention, Africa, PEPFAR

Citation

Loevinsohn, G., Kigozi, G., Kagaayi, J., Wawer, M. J., Nalugoda, F., Chang, L. W., ... & Grabowski, M. K. (2021). Effectiveness of voluntary medical male circumcision for human immunodeficiency virus prevention in Rakai, Uganda. Clinical Infectious Diseases, 73(7), e1946-e1953. DOI: 10.1093/cid/ciaa1533