Human Immunodeficiency Virus Clinical Trial
Official title:
Simplifying the Shang Ring Technique for Circumcision of Men and Boys
This is a research study in Kenya that will examine the outcomes of participants aged 10-15
and 16 and older; and provider acceptability of the Shang Ring technique for male
circumcision that would simplify use. The study will be in two phases:
Phase 1 will explore the no-flip technique that has been used in China but will be used for
the first time in Africa.
Phase 2 will be a randomized trial comparing use of tropical vs. injectable anesthesia.
The study, to be conducted in two phases, will examine procedural and clinical outcomes, as
well as participant and provider acceptability, of adaptations of the Shang Ring technique
for male circumcision that would simplify its use and increase its acceptability.
- Phase I will be non-comparative for exploration of the no-flip technique for Shang Ring
circumcision (i.e. all participants will be circumcised using the no-flip Shang Ring
technique). Historical data from standard Shang Ring circumcisions conducted in Africa
(Kenya, Uganda and Zambia) will be used as the comparison group. Men will be randomized
to removal at 7 days after circumcision vs. delayed removal, to assess occurrence and
safety of spontaneous detachments following circumcision with the no-flip technique.
- Phase 2 will compare the use of topical vs. injectable anesthesia for Shang Ring
circumcision. Participants will be randomized to topical vs. injectable anesthesia in a
2:1 ratio. The investigators rationalize the 2:1 randomization scheme given that the
investigators will have just completed Phase I in which 200 men and boys will have been
circumcised using the no-flip technique with injected anesthesia. However, given the
subjectivity associated with using reported pain as the primary endpoint, the
investigators believe it is critical to randomize participants in this phase of the
study.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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