title: Factors associated with resumption of sex before complete wound healing in circumcised HIV-positive and HIV-negative men in Kisumu, Kenya.
abstract: BACKGROUND
  We evaluated time to resumption of sex in relation to wound healing following circumcision of adult males. The purpose was to assess factors associated with adherence to the WHO recommendation of 42-days postcircumcision sexual abstinence and with engaging in sex before complete healing.
  
  
  METHODS
  Participants were circumcised then followed weekly for 7 weeks and at 3 months. At each follow-up, participants were asked if they had engaged in sex since circumcision and their postcircumcision wounds examined to determine if they were fully healed. Log binomial regression identified risk factors for early sex before 42 days and sex before complete healing.
  
  
  RESULTS
  Overall, 37.7% (120/318) of men reported sex before 42 days and 18.8% (60/319) reported sex before complete healing. Only 7% of men had unprotected sex before complete healing. There were no differences between HIV-positive and HIV-negative men in either healing time or sex before healing. Risk factors for sex before healing were being married or having 2 or more sex partners in the last year. Among single men, age older than 24 years and consistent alcohol consumption were associated with sex before healing.
  
  
  CONCLUSIONS
  The risk of HIV transmission because of unprotected sex before wound healing is low and transient, because most men reporting early sex either used a condom or had wound already healed. Adherence to the 42-day abstinence period and condom use at every sexual intercourse within 3 months postcircumcision should minimize risk of HIV spread because of sex before complete healing.
authors.affiliation: *Nyanza Reproductive Health Society, Kisumu, Kenya †University of Nairobi, Nairobi, Kenya ‡University of Illinois, Chicago, IL.
authors.forename: Elijah
authors.initials: E
authors.lastname: Odoyo-June
authors.forename: John H
authors.initials: JH
authors.lastname: Rogers
authors.forename: Walter
authors.initials: W
authors.lastname: Jaoko
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D007630:Kenya; D008297:Male; D009919:Orchiectomy; D014945:Wound Healing; D055815:Young Adult