Factors associated with resumption of sex before complete wound healing in circumcised HIV-positive and HIV-negative men in Kisumu, Kenya.

Abstract

BACKGROUND:: We evaluated time-to-resumption of sex in relation to wound healing following circumcision of adult males. The purpose was to assess factors associated with adherence to the WHO recommendation of 42-days post-circumcision sexual abstinence and with engaging in sex before complete healing. METHODS:: Participants were circumcised then followed weekly for seven weeks and at three months. At each follow-up, participants were asked if they had engaged in sex since circumcision and their post-circumcision wounds examined to determine if they were fully healed. Log binomial regression identified risk factors for early sex before 42 days and sex before complete healing. RESULTS:: Overall 37.7% (120/318) of men reported sex before 42 days and 18.8% (60/319) reported sex before complete healing. Only 7% of men had unprotected sex before complete healing. There were no differences between HIV-positive and HIV-negative men in either healing time or sex before healing. Risk factors for sex before healing were being married or having two or more sex partners in the past year. Among single men, age above 24 years and consistent alcohol consumption were associated with sex before healing. CONCLUSION:: The risk of HIV transmission due to unprotected sex before wound healing is low and transient, since most men reporting early sex either used a condom or were already healed. Adherence to the 42-day abstinence period and condom use at every sexual intercourse within three months post-circumcision should minimize risk of HIV spread due to sex before complete healing.