Does sex in the early period after circumcision increase HIV-seroconversion risk? Pooled analysis of adult male circumcision clinical trials.
OBJECTIVE
To evaluate whether sexual intercourse soon after adult male circumcision affected HIV risk.


METHODS
Combined analysis of data from African trials of men who were randomized to and underwent circumcision.


METHODS
We examined two associations: early sex (intercourse <42 days after circumcision) and HIV acquisition at 3 months for the Orange Farm and Kisumu trials and at 6 months for the Rakai and Kisumu trials and incomplete wound healing at 1 month and seroconversion at 3 and 6 months for the Kisumu trial and at 6 months for the Rakai trial.


RESULTS
Early sex was reported by 3.9% of participants in Kisumu, 5.4% in Rakai, and 22.5% in Orange Farm. HIV seroprevalence was 0.0% at 3 months and 1.9% at 6 months among 18-24-year-olds reporting early sex and 0.2% at 3 months and 0.6% at 6 months among those who did not report early sex. In pooled analyses, men reporting early sex did not have higher HIV infection risk at 3 or 6 months. In Kisumu, 16 (1.3%) men had incomplete wound healing at the 30-day visit. One (6.3%) of these seroconverted at 3 months compared with 2 (0.2%) of 1246 men with complete wound healing (P = 0.075). No association was observed between incomplete wound healing and seroconversion for Rakai participants.


CONCLUSIONS
Most men delayed intercourse after circumcision. Early sex after circumcision was not associated with HIV risk, although the study power was limited. Nevertheless, men should delay intercourse to limit the potential for increased HIV risk until complete wound healing.
Mehta
Supriya D
SD
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA. supriyad@uic.edu
Gray
Ronald H
RH
Auvert
Bertran
B
Moses
Stephen
S
Kigozi
Godfrey
G
Taljaard
Dirk
D
Puren
Adrien
A
Agot
Kawango
K
Serwadda
David
D
Parker
Corette B
CB
Wawer
Maria J
MJ
Bailey
Robert C
RC
D000293:Adolescent; D002944:Circumcision, Male / Q000009:adverse effects*; D003075:Coitus; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control; D006679:HIV Seropositivity / Q000635:transmission*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012725:Sexual Behavior; D014945:Wound Healing; D055815:Young Adult