Circumcision is a primary preventive against HIV infection: Critique of a contrary meta-regression analysis by Van Howe.
A meta-analysis by Van Howe of 109 populations confirms the well-known association of male circumcision (MC) with reduced HIV prevalence. He then performed meta-regression adjusting for location, risk and MC prevalence. When one or two of these adjustments in combination were applied MC appeared pro...
| Publicado en: | Global Public Health Vol. 13; no. 12; pp. 1889 - 1900 |
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| Autores principales: | , , , |
| Formato: | abstract commentary Journal Article |
| Publicado: |
Taylor & Francis Ltd
Dec2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132459876&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132459876 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17441692 15UG jtl: Global Public Health issn: 17441692 maglogo: N pubinfo: dt: Dec2018 vid: 13 iid: 12 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 132459876 132459876 132459876 10.1080/17441692.2016.1164737 132459876 ppf: 1889 ppct: 11 formats: tig: atl: Circumcision is a primary preventive against HIV infection: Critique of a contrary meta-regression analysis by Van Howe. aug: au: Morris, Brian J. Wamai, Richard G. Barboza, Gia Krieger, John N. affil: School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, Australia sug: subj: Sexually Transmitted Diseases Circumcision Human Immunodeficiency Virus Prevalence HIV Infections Prevention and Control Health Policy ab: A meta-analysis by Van Howe of 109 populations confirms the well-known association of male circumcision (MC) with reduced HIV prevalence. He then performed meta-regression adjusting for location, risk and MC prevalence. When one or two of these adjustments in combination were applied MC appeared protective, but when all three were introduced the association remained significant in high-risk populations, but not in general populations within Africa with a hypothetical MC prevalence of <25% or elsewhere with hypothetical MC prevalence of <75%. However, many MC prevalence values given differed from those reported in references cited (including all US studies). This and other problems invalidate his adjustments for MC prevalence, undermining most of his meta-regression results. Meta-regression is a highly sophisticated statistical tool and is prone to error if not applied correctly. The study contained a high risk of bias arising from confounding. We also question his use of crude, rather than adjusted, odds ratios and his inclusion of unpublished data, so precluding replication by others. Flawed statistics, opaque presentation of results and inclusion of previously repudiated arguments downplaying a role for MC in HIV prevention programmes should lead readers to be sceptical of the findings and conclusions of Van Howe’s study. pubtype: Academic Journal doctype: abstract commentary Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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