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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
HIV prevention: Male circumcision comparison between a nonsurgical device to a surgical technique in resource-limited settings: A prospective, randomized, nonmasked trial
Journal of Acquired Immune Deficiency Syndromes, Volume 61, No. 1, Year 2012
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Description
Background: Randomized controlled trial studies have shown that male circumcision (MC) can reduce the risk of HIV infection by 53%-60%. The Joint United Nations Program on HIV and AIDS announced a 5-year plan to voluntarily circumcise 20 million men by 2015. There are more than 38 million males in sub-Saharan Africa that could benefit from MC for HIV prevention by 2015. Surgical MC is impractical for nation-wide coverage in resource-limited settings. Rwanda intends to launch a voluntary MC program to reach 2 million adult men in 2 years, an unattainable goal with surgical MC. This study was designed to compare a new nonsurgical device with surgical MC to assess nonsurgical MC suitability for scale-up. Methods: Prospective, randomized controlled trial in Rwanda in which the PrePex device was used for nonsurgical MC and the dorsal-slit method for surgical MC (ratio: 2:1). Subjects were healthy adult male volunteers aged 21-54 years. The primary endpoint, set by World Health Organization, was total MC procedure time. FINDINGS:: Of 217 eligible subjects, 144 were randomized to the PrePex/nonsurgical arm and 73 to the surgical arm. All subjects were circumcised in 10 working days. Nonsurgical MC was bloodless, without anesthesia, sutures, or sterile setting and with mean procedure time of 3.1 minutes (skin to skin), was significantly shorter than mean surgical procedure time (15.4 minutes skin to skin) (P < 0.0001). There were no device-related adverse events. Healing time of the PrePex arm was longer than the surgical arm. Conclusion: PrePex, the nonsurgical MC, takes significantly less time than surgical, is as safe, does not require injections or sterile settings, is bloodless and seems to be suitable for nurses. © 2012 Lippincott Williams & Wilkins.
Authors & Co-Authors
Mutabazi, Vincent
Rwanda, Kigali
Ministry of Health
Kaplan, Steven A.
United States, New York
Weill Cornell Medicine
Rwamasirabo, Emile
Rwanda, Kigali
King Faisal Hospital
Bitega, Jean Paul
Rwanda, Kigali
Kanombe Military Hospital
Ngeruka, Muyenzi Leon
Rwanda, Kigali
Kanombe Military Hospital
Savio, Dominique
Rwanda, Kigali
Centre Hospitalier Universitaire de Kigali
Karema, Corine Kakizi
Rwanda, Kigali
Ministry of Health
Binagwaho, Agnès
Rwanda, Kigali
Ministry of Health
United States, Cambridge
Harvard University
Statistics
Citations: 63
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0b013e3182631d69
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Rwanda
Participants Gender
Male