0
Correction |

Incorrect Data Analysis in: Circumcision Status and Risk of HIV and Sexually Transmitted Infections Among Men Who Have Sex With Men: A Meta-analysis

JAMA. 2009;301(11):1126-1129. doi:10.1001/jama.2009.92
Text Size: A A A
Published online
Figures in this Article

Incorrect Data Analysis: In the Review entitled “Circumcision Status and Risk of HIV and Sexually Transmitted Infections Among Men Who Have Sex With Men: A Meta-analysis” published in the October 8, 2008, issue of JAMA (2008;300[14]:1674-1684), the authors have identified an error that occurred in the spreadsheet computations of the random-effects variance estimate. This had the effect of altering the random-effects summary odds ratios, some of the power estimates, and some interpretation of the odds ratios. Although the values have changed, the pattern of nonsignificant findings remains consistent with the originally published article. Based on the corrected reanalysis, the following changes should be made to the text.

In the Data Synthesis section of the Abstract on page 1674, the second sentence should have read as follows: “The odds of being HIV-positive were not significantly lower among MSM who were circumcised than uncircumcised (odds ratio, 0.95; 95% confidence interval, 0.81-1.11; number of independent effect sizes [k] = 15).” The fourth sentence should have read: “Among MSM who primarily engaged in insertive anal sex, the association between male circumcision and HIV was protective but not statistically significant (odds ratio, 0.71; 95% confidence interval, 0.22-2.28; k = 4).” The sixth sentence should have read: “Neither the association between male circumcision and other STIs (odds ratio, 1.06; 95% confidence interval, 0.97-1.15; k = 8) nor its relationship with study quality was statistically significant (β, 0.265; P = .47).”

In the Results section on page 1677, the third sentence of the fourth paragraph should have read: “The weighted overall effect size reflecting the association between circumcision and HIV infection among MSM was statistically nonsignificant (OR, 0.95; 95% CI, 0.81-1.11; k = 15).” The fifth sentence should have read: “There was moderate to high heterogeneity among the 15 findings (I2 = 61%), which warranted further examination via stratified analyses.” The sixth sentence should have read: “Most of the stratified analyses revealed associations that were not statistically significant (Table 2).”The fourth sentence of the fifth paragraph should have read: “The association between circumcision and HIV infection among the subset of higher-quality studies (determined by the Newcastle-Ottawa Scale) was protective, but statistically nonsignificant (OR, 0.84; 95% CI, 0.57-1.24; k = 5; I2 = 53%).” The first sentence of the sixth paragraph should have read: “A separate analysis (not shown in Table 2) of 4 findings from 3 studies29,33,34 reporting HIV infection and circumcision status for MSM who engaged exclusively or primarily in insertive anal intercourse (n = 2238) was protective, but not statistically significant (OR, 0.71; 95% CI, 0.22-2.28; k = 4).” The fourth sentence of the seventh paragraph should have read: “The weighted overall effect size for the association between circumcision status and STI among MSM was not statistically significant (OR, 1.06; 95% CI, 0.97-1.15; k = 8).”

In the Comment section on page 1679, the first sentence of the first paragraph should have read: “In this meta-analysis of 15 observational studies of the association of circumcision status and HIV infection among 53 567 MSM, the odds of being HIV positive among MSM who were circumcised vs among MSM who were uncircumcised were not statistically different.” On page 1680, the second sentence of the first paragraph should have read: “First, we found a statistically significant protective association for circumcision among MSM in studies conducted before the advent of HAART, but no significant association for studies conducted after HAART.” On page 1681, the fourth sentence of the second paragraph should have read: “The aggregated US studies, where circumcision prevalence is relatively high,62 had no significant reduction in odds of HIV infection among circumcised MSM.” The fifth sentence of the second paragraph should have read: “By contrast, the reduction in odds was higher in developing countries (49%) which have lower adult circumcision rates than the United States.”63 On page 1683, the first sentence of the first paragraph should have read: “We found no statistically significant association between circumcision and HIV infection in our meta-analysis of MSM observational studies, and no statistically significant association between circumcision status and STI.”

The corrected Figure 2, Figure 3, Table 2, and Table 3 appear here.

Place holder to copy figure label and caption
Figure 2. Overall Effect Size Estimates for Male Circumcision and HIV Infection Among Men Who Have Sex With Men (14 Studies; 15 Findings)
Grahic Jump Location

HIV denotes human immunodeficiency virus; CI, confidence interval. Odds ratios are from reconstructed 2 × 2 tables and may differ from those in original reports. Odds ratios of less than 1 indicate decreased odds of HIV infection among circumcised men who have sex with men.
aAdditional data were obtained from authors, coauthors, or principal investigators.
bDenotes black participants.
cDenotes Latino participants.

Place holder to copy figure label and caption
Figure 3. Overall Effect Size Estimates for Male Circumcision and STI (Other Than HIV) Among Men Who Have Sex With Men (7 Studies; 8 Findings)
Grahic Jump Location

HIV denotes human immunodeficiency virus; CI, confidence interval; and STI, sexually transmitted infection.
Odds ratios are from reconstructed 2 × 2 tables and may differ from those in original reports. Odds ratios of less than 1 indicate decreased odds of STI among circumcised men who have sex with men.
aDenotes black participants.
bDenotes Latino participants.

Table Grahic Jump LocationTable 2. Odds of HIV Infection Among Circumcised vs Uncircumcised Men Who Have Sex With Men by Study and Design Characteristics

Table Grahic Jump LocationTable 3. Odds of Sexually Transmitted Infections (Other Than HIV) Among Circumcised vs Uncircumcised Men Who Have Sex With Men by Study and Design Characteristics

First Page Preview

First page PDF preview

Figures

Place holder to copy figure label and caption
Figure 2. Overall Effect Size Estimates for Male Circumcision and HIV Infection Among Men Who Have Sex With Men (14 Studies; 15 Findings)
Grahic Jump Location

HIV denotes human immunodeficiency virus; CI, confidence interval. Odds ratios are from reconstructed 2 × 2 tables and may differ from those in original reports. Odds ratios of less than 1 indicate decreased odds of HIV infection among circumcised men who have sex with men.
aAdditional data were obtained from authors, coauthors, or principal investigators.
bDenotes black participants.
cDenotes Latino participants.

Place holder to copy figure label and caption
Figure 3. Overall Effect Size Estimates for Male Circumcision and STI (Other Than HIV) Among Men Who Have Sex With Men (7 Studies; 8 Findings)
Grahic Jump Location

HIV denotes human immunodeficiency virus; CI, confidence interval; and STI, sexually transmitted infection.
Odds ratios are from reconstructed 2 × 2 tables and may differ from those in original reports. Odds ratios of less than 1 indicate decreased odds of STI among circumcised men who have sex with men.
aDenotes black participants.
bDenotes Latino participants.

Tables

Table Grahic Jump LocationTable 2. Odds of HIV Infection Among Circumcised vs Uncircumcised Men Who Have Sex With Men by Study and Design Characteristics
Table Grahic Jump LocationTable 3. Odds of Sexually Transmitted Infections (Other Than HIV) Among Circumcised vs Uncircumcised Men Who Have Sex With Men by Study and Design Characteristics

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.