 |
The safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda
Presented by Godfrey Kigozi, Uganda.
Kigozi G.1, Gray R.2, Wawer M.3, Serwada D.4, Makumbi F.5, Nalugoda F.6
1Rakai Health Sciences Program, Epidemiology, Kalisizo, Uganda, 2JohnsHopkins School of Public Health, Population and Family Health Sciences, Baltimore, United States, 3JohnHopkins School of Public Health, Population and Family Health Sciences, Baltimore, United States, 4Makerere University, Institute of public Health, Kampala, Uganda, 5Makerere University, Institute of Public Health, Kampala, Uganda, 6Rakai Health Science Program, Kalisizo, Uganda
Objectives: To compare the rates of adverse events (AEs) related to circumcision in HIV-positive and HIV-negative men.
Methods: 2,328 HIV-negative men and 420 HIV-positive men were circumcised in two separate trials of male circumcision for HIV prevention in rural Rakai, Uganda. Participants were followed up at 1-2 and 5-9 days, and at 4-6 weeks postoperatively to assess AEs related to surgery, wound healing and resumption of intercourse. AE rates and wound healing were compared between HIV-positive and HIV-negative men. Factors associated with surgery-related AEs were assessed by logistic multiple regression with robust variance estimates to account for multiple AEs within individuals.
Results: At enrollment, HIV-positive men were older, reported more sexual partners, less condom use and had higher rates of STD symptoms than HIV-negative men. Moderate or severe AEs requiring treatment were 3.2% in HIV-positive and 3.6% in HIV-negative participants (adjusted odds ratio 1.02, 95%CI 0.52-2.00). The most common AEs were infections, and the rates of moderate or severe infection were 2.0% in HIV-positive versus 2.1% in HIV-negative men. Rates of other complications were similar in the two groups. The proportion with completed healing by 30 days post-surgery was lower in HIV-positive (71.1%) than HIV-negative men (80.7%, p <0.0001). Multiple regression identified no significant sociodemographic, behavioral or STI symptoms predictive of moderate/severe AEs.
Conclusions: Overall, the safety of circumcision was comparable in HIV-positive and HIV-negative men, although there was somewhat slower wound healing among the HIV-infected participants.
Back to the session -
Back to the Programme-at-a-Glance
|
|