HIV Infections Clinical Trial
Official title:
Randomized Trial of Male Circumcision for HIV Prevention, Rakai, Uganda
Circumcision in HIV unifected men may reduce the likelihood of becoming infected with HIV, reduce sexually transmitted infections (STIs) in men, not engender increases in sexual risk behaviors, and be acceptable to men as a procedure for preventing HIV. The purpose of this study is to evaluate circumcision in HIV uninfected men in terms of safety and ability to prevent HIV infection.
South Africa has one of the most severe and fast-growing HIV epidemics in the world. Adult
male circumcision may be an effective preventive measure to slow the spread of HIV and other
STIs. This study will assess the efficacy of circumcision in HIV uninfected men in
preventing HIV and STI acquisition.
This study will have two stages. In the first stage, 200 men will be enrolled into a study
of the acceptability, feasibility, and safety of circumcision. Frequent postoperative
follow-up will occur to determine rates of healing and complications. After assessment of
those enrolled in Stage 1, Stage 2 enrollment will begin. Stage 2 will determine the
efficacy of circumcision in preventing HIV acquisition. In both stages, HIV uninfected men
will be randomly assigned to have either immediate circumcision or possible circumcision 2
years following Stage 2 study entry. The participants not receiving immediate circumcision
will be offered circumcision after completion of 2 years of follow-up study, provided there
is evidence of the efficacy of this procedure at that time. If efficacy is still unknown
after 2 years of follow-up, participants will be given the option of circumcision at the
completion of the trial.
Postoperative follow-up visits will be scheduled between 24 to 48 hours, 5 to 9 days, and 4
to 6 weeks. At each postoperative visit, participants will be questioned about symptoms
suggestive of complications, and the area operated on will be inspected. Participants will
be asked about resumption of sexual intercourse, and those who have resumed sexual
intercourse will be asked about condom use. Study visits will be also conducted regarding
risk behaviors and symptoms of STIs, and these will occur sometime between Weeks 4 to 6, and
at Months 6, 12, and 24 post-enrollment. At each study visit, assessment of circumcision
status and penile pathology; blood, urine, and penile swabs collection; and HIV testing will
occur, and counseling and health education will be provided.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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