title: Safety of medical male circumcision in human immunodeficiency virus-infected men in Rakai, Uganda.
abstract: OBJECTIVE
  To assess the safety of medical male circumcision (MMC) among human immunodeficiency virus (HIV)-infected men with CD4 levels <350 cells/mm(3), CD4 counts ≥ 350 cells/mm(3), and HIV-negative men.
  
  
  METHODS
  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.
  
  
  RESULTS
  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/mm(3) was 0.79 per 100 surgeries, and among men with CD4 counts <350 cells/mm(3) the rate was 1.19 per 100 surgeries (P = .214). AE rates were comparable for all characteristics (P >.05).
  
  
  CONCLUSIONS
  HIV-positive men can be safely included in MMC roll out programs without necessitating presurgery CD4 counts determination.
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda. Electronic address: gkigozi@rhsp.org.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Richard
authors.initials: R
authors.lastname: Musoke
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Nehemiah
authors.initials: N
authors.lastname: Kighoma
authors.affiliation: Department of Epidemiology and Biostatistics, the School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology and Biostatistics, the School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Makumbi
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.affiliation: Department of Epidemiology and Biostatistics, the School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Wabwire-Mangen
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology and Biostatistics, the School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Maria Joan
authors.initials: MJ
authors.lastname: Wawer
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Ronald Henry
authors.initials: RH
authors.lastname: Gray
mesh_terms: D000328:Adult; D002944:Circumcision, Male / Q000009:adverse effects*; D015658:HIV Infections; D006801:Humans; D008297:Male; D061214:Patient Safety; D011446:Prospective Studies; D014454:Uganda