Shang Ring versus forceps-guided adult male circumcision: a randomized, controlled effectiveness study in southwestern Uganda.

Adult male circumcision (AMC) reduces HIV transmission, but uptake is limited in part by current surgical methods. We randomized HIV-uninfected men (n = 138) to receive Shang Ring (SR)- or forceps-guided AMC from a locally trained surgeon. In as-treated analyses, more SR procedures were completed within 10 minutes (79% versus 0%, P < 0.01) and more subjects reported high satisfaction (77% versus 58%, P = 0.03). Healing time and pain scores were similar, though minor complication rates were higher in SR subjects (56% versus 24%, P < 0.01). SR circumcision is a rapid and acceptable method of AMC and should be further evaluated to increase uptake of AMC.