Circumcision For HIV Prevention in Men Who Have Sex With Men: an Updated Meta-Analysis.
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April 2026
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Available in CDC Stacks on February 25, 2026, 12:00 AM
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Alternative Title:Journal of Acquired Immune Deficiency Syndromes (1999), 2026, v. 101, no. 4: Circumcision For HIV Prevention in Men Who Have Sex With Men: an Updated Meta-Analysis.
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Journal Article:Journal of Acquired Immune Deficiency Syndromes (1999)
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Personal Author:
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Description:Circumcision reduces HIV risk for men who have sex with women, but for men who have sex with men (MSM), prior meta-analyses were ambiguous because of inconsistent, highly confounded data suggesting regional differences. This has left the weight of evidence unclear even after a small 2024 trial in primarily insertive MSM (PI-MSM) in China showed protection. Any protection would be for PI-MSM and could have substantial impact given high incidence.
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We performed an updated literature search on the association of male circumcision with HIV among MSM. We conducted descriptive analyses, and a random-effects meta-analysis among PI-MSM. To isolate the protective effect of circumcision from confounders, we then performed a confounder-adjusted meta-analysis, comparing the effect of circumcision on HIV status among PI-MSM versus other MSM, testing for publication bias (funnel plot asymmetry) and regional heterogeneity (United States/Canada/Europe/Australia vs. Asia/Africa/Latin America).
Forty-nine studies were included in the descriptive analysis, 13 in the unadjusted meta-analysis, and 10 in the confounder-adjusted meta-analysis. In the unadjusted meta-analysis, circumcision was associated with a lower HIV risk among PI-MSM (odds ratio (OR) = 0.57, 95% CI: 0.33 to 0.98); publication bias and heterogeneity were present. In the confounder-adjusted analysis, the additional effect of circumcision in the PI-MSM group-a ratio of ORs-was 0.53 (95% CI: 0.34 to 0.83), a significant, substantial protective association. Regional heterogeneity ( P = 0.65) and publication bias ( P = 0.34) were not present.
Among PI-MSM, circumcision was protective against HIV. Findings support male circumcision as an effective HIV prevention method for PI-MSM. -
Content Notes:Author manuscript
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Source:Journal of Acquired Immune Deficiency Syndromes (1999), 2026, v. 101, no. 4
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DOI:
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ISSN:1525-4135 ; 1944-7884
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Pubmed ID:41729204
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Pubmed Central ID:PMC12931658
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Pages in Document:335-345 (23 pdf pages)
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Volume:101
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Issue:4
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Main Document Checksum:urn:sha-512:24ae21b8c6fe45c33fa07a51ada2317bef88ad6fe9fa9160ee8c5e09616f561bc6e99939efa7b78ced4408fe96daccb5939a679035a449a6ca240ffc958bb7be
Supporting Files
File Language:
English
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