Safety of Medical Male Circumcision in Human Immunodeficiency Virus–Infected Men in Rakai, Uganda

Published:November 27, 2013DOI:


      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.


      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.


      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).


      HIV-positive men can be safely included in MMC roll out programs without necessitating presurgery CD4 counts determination.
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