Safety of Medical Male Circumcision in Human Immunodeficiency Virus–Infected Men in Rakai, Uganda

ObjectiveTo assess the safety of medical male circumcision (MMC) among human immunodeficiency virus (HIV)–infected men with CD4 levels <350 cells/mm3, CD4 counts ≥350 cells/mm3, and HIV-negative men.MethodsTwo 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.ResultsOverall, 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/mm3 was 0.79 per 100 surgeries, and among men with CD4 counts <350 cells/mm3 the rate was 1.19 per 100 surgeries (P = .214). AE rates were comparable for all characteristics (P >.05).ConclusionHIV-positive men can be safely included in MMC roll out programs without necessitating presurgery CD4 counts determination.