Authors: Krieger JN, Bailey RC, Opeya J, Ayieko B, Opiyo F, Agot K, Parker C, Ndinya-Achola JO,
Magoha GA, Moses S.
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
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.
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.
Safe and acceptable adult male circumcision services can be delivered in developing countries
should male circumcision ultimately be advocated as a public-health measure.
BJU Int. 2005 Nov; 96(7):1109-13. PubMed PMID: 16225538
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