Male Circumcision and HIV Rates in Kenya - Full Text View

Purpose

The Luo tribe of Kisumu, Kenya, does not traditionally practice male circumcision (MC). This study will work with the Luo tribe to test the effectiveness of MC on reducing the risk of HIV infections in young men.

Condition	Intervention	Phase
HIV Infections	Procedure: male circumcision	Phase III

MedlinePlus related topics:

AIDS Circumcision Sexually Transmitted Diseases

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Prevention, Randomized, Open Label, Placebo Control, Factorial Assignment, Safety/Efficacy Study

Official Title:	Trial of Male Circumcision to Reduce HIV Incidence

Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:

HIV incidence [ Time Frame: 2 years ] [ Designated as safety issue: No ]
surgical complications [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

incidence of other sexually transmitted diseases [ Time Frame: 2 years ] [ Designated as safety issue: No ]
behavioral risks [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Enrollment:	2887
Study Start Date:	February 2002
Study Completion Date:	December 2006
Primary Completion Date:	October 2006 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Circumcised immediately: Active Comparator	Procedure: male circumcision
Delayed Circumcision: Placebo Comparator Men who were randomized to delayed circumcision were scheduled to be offered male circumcision 2 years after their randomization.	Procedure: male circumcision

Detailed Description:

Since 1989, numerous epidemiological studies have reported a significant association between lack of male circumcision (MC) and risk for HIV infection through heterosexual intercourse. These results have led to calls for male circumcision to be considered as an additional HIV prevention strategy. However, there is a consensus among the international health community that a randomized controlled trial of MC is needed to control for possible confounding factors. Additionally, known risks associated with MC need further investigation. This study will assess the effectiveness of male circumcision in reducing HIV incidence and will evaluate complications of the MC procedure, changes in sexual behavior following circumcision, and the biological mechanisms by which the foreskin may increase HIV susceptibility. The study will be conducted in Kisumu, Kenya, where the Luo tribe is the main ethnic group and less than 10% of adult men are circumcised.

Uncircumcised men aged 18 to 24 years old will be offered voluntary HIV counseling and testing. HIV negative men will be asked to enroll in the study. All study participants will be interviewed to obtain socio-demographic information and assess behavioral risk factors. Participants will be examined for significant medical conditions. All men will be counseled in strategies to reduce their risk for HIV infection. Consenting men will be randomly assigned to either the treatment (circumcised) arm or the control (uncircumcised) arm of the study. After circumcision, men will be monitored for complications. They will be counseled to abstain from sex until healing is complete. Follow-up visits will occur every 6 months for 2 years. Uncircumcised men will be offered circumcision at the end of follow-up.

The primary study endpoints will be HIV incidence and surgical complications. Additional outcomes will be the incidence of other sexually transmitted diseases and behavioral risks. Additional laboratory studies of foreskin tissue will evaluate the number and density of specialized cells rich in HIV receptors in order to illuminate the biological mechanisms by which presence of foreskin may increase HIV susceptibility.

Eligibility

Ages Eligible for Study:	18 Years to 24 Years
Genders Eligible for Study:	Male
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria

HIV uninfected and willing to be tested
Live in Kisumu District, Kenya
Uncircumcised but willing to be circumcised
At least one sexual partner in the 12 months prior to study entry

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00059371

Locations


Kenya
	UNIM Clinic
	Kisumu, Kenya

Sponsors and Collaborators

National Institute of Allergy and Infectious Diseases (NIAID)

Investigators


Principal Investigator:	Robert C. Bailey, PhD, MPH	University of Illinois

More Information

Publications indexed to this study:

Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CF, Campbell RT, Ndinya-Achola JO. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007 Feb 24;369(9562):643-56.

Responsible Party:	NIAID ( Carolyn Williams, Chief Epidemiology )
Study ID Numbers:	5U01AI050440-02
First Received:	April 23, 2003
Last Updated:	May 28, 2008
ClinicalTrials.gov Identifier:	NCT00059371
Health Authority:	United States: Federal Government

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):

Male circumcision

HIV acquisition

Sexually transmitted infection

HIV Seronegativity

Study placed in the following topic categories:

Virus Diseases

Sexually Transmitted Diseases, Viral

HIV Infections

Sexually Transmitted Diseases

Acquired Immunodeficiency Syndrome

Retroviridae Infections

Immunologic Deficiency Syndromes

Additional relevant MeSH terms:

RNA Virus Infections

Slow Virus Diseases

Immune System Diseases

Lentivirus Infections

Infection

ClinicalTrials.gov processed this record on November 30, 2008

Sponsored by:	National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by:	National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:	NCT00059371