%0 Journal Article %T Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. %+ Hôpital Ambroise Paré [AP-HP] %+ Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé %+ Progressus %+ National Institute for Communicable Diseases [Johannesburg] (NICD) %A Auvert, Bertran %A Taljaard, Dirk %A Lagarde, Emmanuel %A Sobngwi-Tambekou, Joëlle %A Sitta, Rémi %A Puren, Adrian %< avec comité de lecture %@ 1549-1277 %J PLoS Medicine %I Public Library of Science %V 2 %N 11 %P e298 %8 2005-11 %D 2005 %R 10.1371/journal.pmed.0020298 %M 16231970 %Z Life Sciences [q-bio]/Human health and pathology/Infectious diseasesJournal articles %X BACKGROUND: Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis. METHODS AND FINDINGS: A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR) of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 - RR. The trial was stopped at the interim analysis, and the mean (interquartile range) follow-up was 18.1 mo (13.0-21.0) when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years) in the intervention group and 49 (2.1 per 100 person-years) in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001). This RR corresponds to a protection of 60% (95% CI: 32%-76%). When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%). CONCLUSION: Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil.). %G English %2 https://inserm.hal.science/inserm-00700701/document %2 https://inserm.hal.science/inserm-00700701/file/journal.pmed.0020298.pdf %L inserm-00700701 %U https://inserm.hal.science/inserm-00700701 %~ INSERM %~ UNIV-PARIS5 %~ UNIV-PARIS1 %~ CNRS %~ UNIV-PSUD %~ EHESS %~ IFR69 %~ APHP %~ UVSQ %~ UNIV-PARIS-SACLAY %~ UNIV-PSUD-SACLAY %~ UNIV-PARIS