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The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda
BACKGROUND: 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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2008
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408615/ https://www.ncbi.nlm.nih.gov/pubmed/18532873 http://dx.doi.org/10.1371/journal.pmed.0050116 |
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author | Kigozi, Godfrey Gray, Ronald H Wawer, Maria J Serwadda, David Makumbi, Frederick Watya, Stephen Nalugoda, Fred Kiwanuka, Noah Moulton, Lawrence H Chen, Michael Z Sewankambo, Nelson K Wabwire-Mangen, Fred Bacon, Melanie C Ridzon, Renee Opendi, Pius Sempijja, Victor Settuba, Absolom Buwembo, Denis Kiggundu, Valerian Anyokorit, Margaret Nkale, James Kighoma, Nehemia Charvat, Blake |
author_facet | Kigozi, Godfrey Gray, Ronald H Wawer, Maria J Serwadda, David Makumbi, Frederick Watya, Stephen Nalugoda, Fred Kiwanuka, Noah Moulton, Lawrence H Chen, Michael Z Sewankambo, Nelson K Wabwire-Mangen, Fred Bacon, Melanie C Ridzon, Renee Opendi, Pius Sempijja, Victor Settuba, Absolom Buwembo, Denis Kiggundu, Valerian Anyokorit, Margaret Nkale, James Kighoma, Nehemia Charvat, Blake |
author_sort | Kigozi, Godfrey |
collection | PubMed |
description | BACKGROUND: 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/mm(3)) 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 HIV-positive 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 HIV-positive men and 95.8% in HIV-negative men (p = 0.007). AEs were more common in men who resumed intercourse before wound healing compared to those who waited (AdjOR 1.56, 95% CI 1.05–2.33). CONCLUSIONS: 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. Trial registration: http://www.ClinicalTrials.gov; for HIV-negative men, #NCT00047073 and for HIV-positive men, #NCT00047073. |
format | Text |
id | pubmed-2408615 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-24086152008-06-03 The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda Kigozi, Godfrey Gray, Ronald H Wawer, Maria J Serwadda, David Makumbi, Frederick Watya, Stephen Nalugoda, Fred Kiwanuka, Noah Moulton, Lawrence H Chen, Michael Z Sewankambo, Nelson K Wabwire-Mangen, Fred Bacon, Melanie C Ridzon, Renee Opendi, Pius Sempijja, Victor Settuba, Absolom Buwembo, Denis Kiggundu, Valerian Anyokorit, Margaret Nkale, James Kighoma, Nehemia Charvat, Blake PLoS Med Research Article BACKGROUND: 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/mm(3)) 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 HIV-positive 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 HIV-positive men and 95.8% in HIV-negative men (p = 0.007). AEs were more common in men who resumed intercourse before wound healing compared to those who waited (AdjOR 1.56, 95% CI 1.05–2.33). CONCLUSIONS: 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. Trial registration: http://www.ClinicalTrials.gov; for HIV-negative men, #NCT00047073 and for HIV-positive men, #NCT00047073. Public Library of Science 2008-06 2008-06-03 /pmc/articles/PMC2408615/ /pubmed/18532873 http://dx.doi.org/10.1371/journal.pmed.0050116 Text en Copyright: © 2008 Kigozi et al. This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. |
spellingShingle | Research Article Kigozi, Godfrey Gray, Ronald H Wawer, Maria J Serwadda, David Makumbi, Frederick Watya, Stephen Nalugoda, Fred Kiwanuka, Noah Moulton, Lawrence H Chen, Michael Z Sewankambo, Nelson K Wabwire-Mangen, Fred Bacon, Melanie C Ridzon, Renee Opendi, Pius Sempijja, Victor Settuba, Absolom Buwembo, Denis Kiggundu, Valerian Anyokorit, Margaret Nkale, James Kighoma, Nehemia Charvat, Blake The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda |
title | The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda |
title_full | The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda |
title_fullStr | The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda |
title_full_unstemmed | The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda |
title_short | The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda |
title_sort | safety of adult male circumcision in hiv-infected and uninfected men in rakai, uganda |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408615/ https://www.ncbi.nlm.nih.gov/pubmed/18532873 http://dx.doi.org/10.1371/journal.pmed.0050116 |
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