Objective
To assess the safety of medical male circumcision (MMC) among human immunodeficiency
virus (HIV)–infected men with CD4 levels <350 cells/mm3, CD4 counts ≥350 cells/mm3, and HIV-negative men.
Methods
Two hundred forty-two HIV-infected men and a sample of 262 HIV-negative consenting
men aged 12 years or older who requested free MMC were enrolled in a prospective study.
Blood for HIV testing and a CD4 count were collected before surgery. During weekly
follow-up over 6 weeks, data were collected on wound healing and adverse events (AEs)
by examination, and resumption of sex and condom use ascertained by interview. Surgery-related
AEs were characterized by type, severity, management, and resolution. Chi-square and
Fisher's exact tests were used to test for differences in AE proportions.
Results
Overall, only 2 of the 453 men experienced moderate AEs, a rate of 0.44 per 100 surgeries.
No AE occurred among HIV-negative men, whereas the AE rate among HIV-infected men
with CD4 counts ≥350 cells/mm3 was 0.79 per 100 surgeries, and among men with CD4 counts <350 cells/mm3 the rate was 1.19 per 100 surgeries (P = .214). AE rates were comparable for all characteristics (P >.05).
Conclusion
HIV-positive men can be safely included in MMC roll out programs without necessitating
presurgery CD4 counts determination.
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References
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World Health Organization. Manual for male circumcision under local anaesthesia. Version 3.1, December 2009. Available at: http://www.who.int/hiv/pub/malecircumcision/who_mc_local_anaesthesia.pdf. Accessed August 2013.
Article info
Publication history
Published online: November 27, 2013
Accepted:
August 17,
2013
Received:
April 5,
2013
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: The study was funded by Bill Melinda Gates Foundation and supported by an African Doctoral Dissertation Research Fellowship.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
