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|Title: ||The Safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda|
|Authors: ||Kigozi, Godfrey|
H. Gray, Ronald
Wawer, Maria J.
Moulton, Lawrence H.
Chen, Michael Z.
Sewankambo, Nelson K.
Bacon, Melanie C.
|Keywords: ||Male circumcision|
Sexually transmitted diseases
|Issue Date: ||3-Jun-2008 |
|Publisher: ||Public Library of Science|
|Citation: ||Kigozi, G. et al (2008). The Safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda. Plos Medicine, 5(6):0911-0918|
The objective of the study was to compare rates of adverse events (AEs) related to male
circumcision (MC) in HIV-positive and HIV-negative men in order to provide guidance for MC
programs that may provide services to HIV-infected and uninfected men.
Methods and Findings:
A total of 2,326 HIV-negative and 420 HIV-positive men (World Health Organization [WHO]
stage I or II and CD4 counts . 350 cells/mm3) were circumcised in two separate but
procedurally identical trials of MC for HIV and/or sexually transmitted infection prevention in
rural Rakai, Uganda. Participants were followed at 1–2 d and 5–9 d, and at 4–6 wk, to assess
surgery-related AEs, wound healing, and resumption of intercourse. AE risks and wound healing
were compared in HIV-positive and HIV-negative men. Adjusted odds ratios (AdjORs) were
estimated by multiple logistic regression, adjusting for baseline characteristics and postoperative
resumption of sex. At enrollment, HIV-positive men were older, more likely to be
married, reported more sexual partners, less condom use, and higher rates of sexually
transmitted disease symptoms than HIV-negative men. Risks of moderate or severe AEs were
3.1/100 and 3.5/100 in HIV-positive and HIV-negative participants, respectively (AdjOR 0.91,
95% confidence interval [CI] 0.47–1.74). Infections were the most common AEs (2.6/100 in HIVpositive
versus 3.0/100 in HIV-negative men). Risks of other complications were similar in the
two groups. The proportion with completed healing by 6 wk postsurgery was 92.7% in HIVpositive
men and 95.8% in HIV-negative men (p¼0.007). AEs were more common in men who
resumed intercourse before wound healing compared to those who waited (AdjOR 1.56, 95% CI
Overall, the safety of MC was comparable in asymptomatic HIV-positive and HIV-negative
men, although healing was somewhat slower among the HIV infected. All men should be
strongly counseled to refrain from intercourse until full wound healing is achieved.|
|Appears in Collections:||Research Articles (Health-Sciences)|
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