To ascertain clinical sequelae, client satisfaction and
sexual behavior 2+ years after male circumcision using the ShangRing device.
We enrolled 199 men from the Kenya sites (Homa Bay district)
participating in a 2012 study of the ShangRing device used in routine male
circumcision services (N = 552). We enrolled men who had had the ShangRing
placed successfully, and over-sampled men who had had an adverse event and/or
were HIV-positive during the field study. In the present study, each
participant was examined and interviewed by a study clinician, and penile
photographs were taken to document longer-term cosmetic results and any abnormal
findings.
194 men were included in the analysis.
- The mean and median times between circumcision and the longer-term follow-up visit in this study were 31.8 and 32 months, respectively.
- Four men (2.1%) had signs/symptoms of a sexually transmitted infection (STI).
- Virtually all (99.5%) of the men were very satisfied with the appearance of their circumcised penis, and all would recommend a ShangRing circumcision to friends or family members.
- The most prevalent reported advantage of the circumcision was the ease of bathing and enhanced cleanliness of the penis (75.8%).
- 94.3% of the men did not cite a single negative feature of their circumcision.
- 87.5% of men reported more sexual pleasure post-MC, the most common reason being more prolonged intercourse.
- 52.6% reported one sexual partner post-MC, but 28.1% reported an increased number of partners post-MC.
- 44.3% reported using condoms half of the time or more, but the great majority of condom users stated that condom use was much easier post-MC, and 76.9% of users said they used condoms more after circumcision than before.
This study supports the safety and acceptability of
ShangRing male circumcision during 2–3 years of follow-up. It should allay
worries that the ShangRing procedure could lead to delayed complications later
than the observation period of most clinical studies.
Below: Typical Penile Appearance at Longer-term Follow-up
2Homa Bay District Hospital, Homa Bay, Kenya
3FHI 360, Nairobi, Kenya
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