The Acceptability and Safety of the Shang Ring for Adult Male Circumcision in Rakai, Uganda

被引：39

作者：

Kigozi, Godfrey ^{[1
]}

Musoke, Richard ^{[1
]}

Watya, Stephen ^{[1
,2
]}

Kighoma, Nehemiah ^{[1
]}

Ssebbowa, Paschal ^{[1
]}

Serwadda, David ^{[1
,3
]}

Nalugoda, Fred ^{[1
]}

Makumbi, Frederick ^{[1
,3
]}

Li, Philip ^{[4
]}

Lee, Richard ^{[4
]}

Goldstein, Marc ^{[4
]}

Wawer, Maria ^{[1
,5
]}

Sewankambo, Nelson ^{[1
,6
]}

Gray, Ronald H. ^{[1
,5
]}

机构：

[1] Rakai Hlth Sci Program, Entebbe, Uganda

[2] Mulago Hosp, Dept Urol, Kampala, Uganda

[3] Makerere Univ, Sch Publ Hlth, Kampala, Uganda

[4] Cornell Univ, Dept Urol, Weill Cornell Med Coll, New York, NY 10021 USA

[5] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA

[6] Makerere Univ, Coll Hlth Sci, Kampala, Uganda

来源：

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES | 2013年 / 63卷 / 05期

基金：

美国国家卫生研究院;

关键词：

male circumcision; Shang ring; Rakai; Uganda; RANDOMIZED CONTROLLED-TRIAL; HIV PREVENTION; MEN;

D O I：

10.1097/QAI.0b013e3182968dda

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objectives: Medical male circumcision (MMC) is recommended for HIV prevention in men. We assessed the acceptability and safety of the Shang Ring device compared with those of the dorsal slit method. Methods: HIV-negative, uncircumcised men aged 18 years or older who requested free MMC services in rural Rakai, Uganda, were informed about the Shang Ring and dorsal slit procedures and offered a free choice of procedure. Men were followed at 7 days postoperatively to assess adverse events related to surgery and to remove the Shang Ring. Wound healing was assessed at 4 weeks postoperatively. Results: Six hundred twenty-one men were enrolled, of whom 508 (81.8%) chose the Shang Ring and 113 the dorsal slit. The Shang Ring was provided to 504 men, among whom there were 4 failures of Ring placement (0.8%) that required surgical hemostasis and wound closure. Five hundred men received the Shang Ring and postoperative surgery-related moderate adverse events were 1.0%, compared with 0.8% among dorsal slit recipients. Complete wound healing at 4 weeks was 84% with the Ring and 100% with the dorsal slit (P, 0001). Resumption of intercourse before 4 weeks was 7.0% with the Ring and 15.0% with the dorsal slit (P = 0.01.) The mean time for surgery was 6.1 minutes with the Ring and 17.7 minutes with the dorsal slit. The mean time for Ring removal was 2.2 minutes. Conclusions: The Shang Ring is highly acceptable and safe in this setting, and could improve the efficiency of MMC services. However, back-up surgical services are needed in cases of Ring placement failures.

引用

页码：617 / 621

页数：5

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