OBJECTIVE: To develop a standard procedure for male circumcision in a resource-poor medical setting and prospectively evaluate the outcome in a randomized, controlled trial with the incidence of human immunodeficiency virus (HIV) as the main outcome, as studies suggest that circumcision is associated with a lower incidence of HIV and other sexually transmitted infections in high-risk populations. SUBJECTS AND METHODS: Healthy, uncircumcised, HIV-seronegative men aged 18-24 years from Kisumu District, Kenya, were offered participation in a clinical trial using a standard circumcision procedure based on "usual" medical procedures in Western Kenya. The follow-up included visits at 3, 8 and 30 days after circumcision, with additional visits if necessary. Healing, satisfaction and resumption of activities were assessed at these visits and 3 months from randomization. RESULTS: Overall, 17 (3.5%) of the 479 circumcisions were associated with adverse events judged definitely, probably or possibly related to the procedure. The most common adverse events were wound infections (1.3%), bleeding (0.8%), and delayed wound healing or suture line disruption (0.8%). After 30 days, 99% of participants reported being very satisfied with the procedure; approximately 23% reported having had sex and 15% reported that their partners had expressed an opinion, all of whom were very satisfied with the outcome. About 96% of the men resumed normal general activities within the first week after the procedure. CONCLUSION: Safe and acceptable adult male circumcision services can be delivered in developing countries should male circumcision ultimately be advocated as a public-health measure.
RCT Entities:
OBJECTIVE: To develop a standard procedure for male circumcision in a resource-poor medical setting and prospectively evaluate the outcome in a randomized, controlled trial with the incidence of human immunodeficiency virus (HIV) as the main outcome, as studies suggest that circumcision is associated with a lower incidence of HIV and other sexually transmitted infections in high-risk populations. SUBJECTS AND METHODS: Healthy, uncircumcised, HIV-seronegative men aged 18-24 years from Kisumu District, Kenya, were offered participation in a clinical trial using a standard circumcision procedure based on "usual" medical procedures in Western Kenya. The follow-up included visits at 3, 8 and 30 days after circumcision, with additional visits if necessary. Healing, satisfaction and resumption of activities were assessed at these visits and 3 months from randomization. RESULTS: Overall, 17 (3.5%) of the 479 circumcisions were associated with adverse events judged definitely, probably or possibly related to the procedure. The most common adverse events were wound infections (1.3%), bleeding (0.8%), and delayed wound healing or suture line disruption (0.8%). After 30 days, 99% of participants reported being very satisfied with the procedure; approximately 23% reported having had sex and 15% reported that their partners had expressed an opinion, all of whom were very satisfied with the outcome. About 96% of the men resumed normal general activities within the first week after the procedure. CONCLUSION: Safe and acceptable adult male circumcision services can be delivered in developing countries should male circumcision ultimately be advocated as a public-health measure.
Authors: James M Hotaling; Laura S Leddy; Mahum A Haider; Matthew Mossanen; Michael R Bailey; Brian MacConaghy; Francis Olson; John N Krieger Journal: Fertil Steril Date: 2014-03-06 Impact factor: 7.329
Authors: John N Krieger; Supriya D Mehta; Robert C Bailey; Kawango Agot; Jeckoniah O Ndinya-Achola; Corette Parker; Stephen Moses Journal: J Sex Med Date: 2008-08-28 Impact factor: 3.802
Authors: Valerian Kiggundu; Stephen Watya; Godfrey Kigozi; David Serwadda; Fred Nalugoda; Denis Buwembo; Absolom Settuba; Margaret Anyokorit; James Nkale; Nehemiah Kighoma; Victor Ssempijja; Maria Wawer; Ronald H Gray Journal: BJU Int Date: 2009-04-21 Impact factor: 5.588
Authors: Supriya D Mehta; Ronald H Gray; Bertran Auvert; Stephen Moses; Godfrey Kigozi; Dirk Taljaard; Adrien Puren; Kawango Agot; David Serwadda; Corette B Parker; Maria J Wawer; Robert C Bailey Journal: AIDS Date: 2009-07-31 Impact factor: 4.177