Cargando…

Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study

BACKGROUND: While voluntary medical male circumcision (VMMC) has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort stu...

Descripción completa

Detalles Bibliográficos
Autores principales: Rogers, John H., Odoyo-June, Elijah, Jaoko, Walter, Bailey, Robert C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626701/
https://www.ncbi.nlm.nih.gov/pubmed/23613918
http://dx.doi.org/10.1371/journal.pone.0061725
_version_ 1782266234192003072
author Rogers, John H.
Odoyo-June, Elijah
Jaoko, Walter
Bailey, Robert C.
author_facet Rogers, John H.
Odoyo-June, Elijah
Jaoko, Walter
Bailey, Robert C.
author_sort Rogers, John H.
collection PubMed
description BACKGROUND: While voluntary medical male circumcision (VMMC) has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort study evaluates post-circumcision wound healing to determine whether the 42-day post-circumcision abstinence period, recommended by the World Health Organization and adopted by VMMC programs, is optimal. METHODS AND FINDINGS: Men were circumcised by forceps-guided method and their post-circumcision wounds examined weekly for seven weeks and at 12 weeks. Time to complete healing was recorded in completed weeks since circumcision, and its associations with baseline covariates were assessed by Kaplan-Meier methods and Cox Proportional Hazard Models. A total of 215 HIV-negative and 108 HIV-positive men aged 18–35 years (median 26, IQR 23–30) were enrolled. 97.1% of scheduled follow-up visits were completed. At week 4, 59.3% of HIV-positive men and 70.4% of age-matched HIV-negative men were healed. At week 6, these percentages rose to 93.4% in HIV-positive men and 92.6% in age-matched HIV-negative men. There was no difference in the hazard of healing between 108 HIV-positive and 108 age-matched HIV-negative men (HR 0.91 95% CI 0.70–1.20). Early post-operative infection was associated with delayed healing in both HIV-positive and HIV-negative men (HR 0.48 95% CI 0.23–1.00). CONCLUSIONS: Our results indicate that the WHO recommendation for 42-days post-circumcision sexual abstinence should be maintained for both HIV-positive and HIV-negative men. It is important to stress condom use upon resumption of sex in all men undergoing circumcision.
format Online
Article
Text
id pubmed-3626701
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-36267012013-04-23 Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study Rogers, John H. Odoyo-June, Elijah Jaoko, Walter Bailey, Robert C. PLoS One Research Article BACKGROUND: While voluntary medical male circumcision (VMMC) has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort study evaluates post-circumcision wound healing to determine whether the 42-day post-circumcision abstinence period, recommended by the World Health Organization and adopted by VMMC programs, is optimal. METHODS AND FINDINGS: Men were circumcised by forceps-guided method and their post-circumcision wounds examined weekly for seven weeks and at 12 weeks. Time to complete healing was recorded in completed weeks since circumcision, and its associations with baseline covariates were assessed by Kaplan-Meier methods and Cox Proportional Hazard Models. A total of 215 HIV-negative and 108 HIV-positive men aged 18–35 years (median 26, IQR 23–30) were enrolled. 97.1% of scheduled follow-up visits were completed. At week 4, 59.3% of HIV-positive men and 70.4% of age-matched HIV-negative men were healed. At week 6, these percentages rose to 93.4% in HIV-positive men and 92.6% in age-matched HIV-negative men. There was no difference in the hazard of healing between 108 HIV-positive and 108 age-matched HIV-negative men (HR 0.91 95% CI 0.70–1.20). Early post-operative infection was associated with delayed healing in both HIV-positive and HIV-negative men (HR 0.48 95% CI 0.23–1.00). CONCLUSIONS: Our results indicate that the WHO recommendation for 42-days post-circumcision sexual abstinence should be maintained for both HIV-positive and HIV-negative men. It is important to stress condom use upon resumption of sex in all men undergoing circumcision. Public Library of Science 2013-04-15 /pmc/articles/PMC3626701/ /pubmed/23613918 http://dx.doi.org/10.1371/journal.pone.0061725 Text en © 2013 Rogers et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Rogers, John H.
Odoyo-June, Elijah
Jaoko, Walter
Bailey, Robert C.
Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study
title Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study
title_full Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study
title_fullStr Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study
title_full_unstemmed Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study
title_short Time to Complete Wound Healing in HIV-Positive and HIV-Negative Men following Medical Male Circumcision in Kisumu, Kenya: A Prospective Cohort Study
title_sort time to complete wound healing in hiv-positive and hiv-negative men following medical male circumcision in kisumu, kenya: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626701/
https://www.ncbi.nlm.nih.gov/pubmed/23613918
http://dx.doi.org/10.1371/journal.pone.0061725
work_keys_str_mv AT rogersjohnh timetocompletewoundhealinginhivpositiveandhivnegativemenfollowingmedicalmalecircumcisioninkisumukenyaaprospectivecohortstudy
AT odoyojuneelijah timetocompletewoundhealinginhivpositiveandhivnegativemenfollowingmedicalmalecircumcisioninkisumukenyaaprospectivecohortstudy
AT jaokowalter timetocompletewoundhealinginhivpositiveandhivnegativemenfollowingmedicalmalecircumcisioninkisumukenyaaprospectivecohortstudy
AT baileyrobertc timetocompletewoundhealinginhivpositiveandhivnegativemenfollowingmedicalmalecircumcisioninkisumukenyaaprospectivecohortstudy