PMID- 18532873
OWN - NLM
STAT- MEDLINE
DCOM- 20080731
LR  - 20211020
IS  - 1549-1676 (Electronic)
IS  - 1549-1277 (Print)
IS  - 1549-1277 (Linking)
VI  - 5
IP  - 6
DP  - 2008 Jun 3
TI  - The safety of adult male circumcision in HIV-infected and uninfected men in 
      Rakai, Uganda.
PG  - e116
LID - 10.1371/journal.pmed.0050116 [doi]
LID - e116
AB  - 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/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 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 #NCT00425984 
      and for HIV-positive men, #NCT000124878.
FAU - Kigozi, Godfrey
AU  - Kigozi G
AD  - Rakai Health Sciences Program, Entebbe, Uganda.
FAU - Gray, Ronald H
AU  - Gray RH
FAU - Wawer, Maria J
AU  - Wawer MJ
FAU - Serwadda, David
AU  - Serwadda D
FAU - Makumbi, Frederick
AU  - Makumbi F
FAU - Watya, Stephen
AU  - Watya S
FAU - Nalugoda, Fred
AU  - Nalugoda F
FAU - Kiwanuka, Noah
AU  - Kiwanuka N
FAU - Moulton, Lawrence H
AU  - Moulton LH
FAU - Chen, Michael Z
AU  - Chen MZ
FAU - Sewankambo, Nelson K
AU  - Sewankambo NK
FAU - Wabwire-Mangen, Fred
AU  - Wabwire-Mangen F
FAU - Bacon, Melanie C
AU  - Bacon MC
FAU - Ridzon, Renee
AU  - Ridzon R
FAU - Opendi, Pius
AU  - Opendi P
FAU - Sempijja, Victor
AU  - Sempijja V
FAU - Settuba, Absolom
AU  - Settuba A
FAU - Buwembo, Denis
AU  - Buwembo D
FAU - Kiggundu, Valerian
AU  - Kiggundu V
FAU - Anyokorit, Margaret
AU  - Anyokorit M
FAU - Nkale, James
AU  - Nkale J
FAU - Kighoma, Nehemia
AU  - Kighoma N
FAU - Charvat, Blake
AU  - Charvat B
LA  - eng
SI  - ClinicalTrials.gov/NCT00425984
SI  - ClinicalTrials.gov/NCT00124878
SI  - ClinicalTrials.gov/NCT00425984
GR  - U01 AI051171/AI/NIAID NIH HHS/United States
GR  - 5D43TW001508/TW/FIC NIH HHS/United States
GR  - U1AI51171/AI/NIAID NIH HHS/United States
GR  - D43TW00015/TW/FIC NIH HHS/United States
GR  - D43 TW001508/TW/FIC NIH HHS/United States
GR  - ImNIH/Intramural NIH HHS/United States
GR  - T22 TW000015/TW/FIC NIH HHS/United States
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - PLoS Med
JT  - PLoS medicine
JID - 101231360
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Circumcision, Male/methods/*standards
MH  - Follow-Up Studies
MH  - HIV Infections/*epidemiology/*prevention & control/transmission
MH  - *HIV Seronegativity
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - Uganda/epidemiology
PMC - PMC2408615
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2008/06/06 09:00
MHDA- 2008/08/01 09:00
PMCR- 2008/06/01
CRDT- 2008/06/06 09:00
PHST- 2007/08/27 00:00 [received]
PHST- 2008/04/17 00:00 [accepted]
PHST- 2008/06/06 09:00 [pubmed]
PHST- 2008/08/01 09:00 [medline]
PHST- 2008/06/06 09:00 [entrez]
PHST- 2008/06/01 00:00 [pmc-release]
AID - 07-PLME-RA-1377 [pii]
AID - 07-PLME-RA-1377R3 [pii]
AID - 10.1371/journal.pmed.0050116 [doi]
PST - ppublish
SO  - PLoS Med. 2008 Jun 3;5(6):e116. doi: 10.1371/journal.pmed.0050116.