1. Evaluation of the AccuCirc Device for Early Infant Male Circumcision in Kisumu, Kenya: Uptake and Safety
Irene Nyaboke1, Valentine Pengo1, Mildred Adhiambo1, Stella Ojuok1, Erick Okello1, Fredrick Otieno1, Rebeca Plank2, Robert C. Bailey3
1Nyanza Reproductive Health Society, Kisumu, Kenya 2Brigham and Women's Hospital, Division of Infectious Diseases, Massachusetts, USA 3School of Public Health, University of Illinois at Chicago, Chicago, USA
AIDS 2016 – Durban, South Africa Poster : WEPDC0102 Contact: Robert

2. Background
As countries in sub-Saharan Africa scale up medical male circumcision (MMC), they are considering long term sustainable strategies, including early infant male circumcision (EIMC).

3. Methods Infant boys are recruited at MNCH clinics and maternity wards
Eligibility criteria:
Age ≤ 60 days
Normal physical and genital exam
No history of bleeding
Meet weight for age standard (>-2 Z-scores)
Questionnaires to mothers assessing knowledge and levels of satisfaction
Follow up at 3 days post circumcision or as needed

4. Results 600 infants circumcised; 596 mothers enrolled
Characteristics of mothers:
Median age: 26 years (IQR=22,30)
Unmarried: 21%
Education: 58% had more than primary education
Characteristics of infants:
Median age: 16 days (IQR=7,33);
28% were ≤7 days and 71% were ≤30 days
Median weight: 3.9kg (IQR=3.5, 4.7)

5. Adverse Events and Device Related Events
17 (2.8%) moderate AEs, all due to bleeding
No serious AEs (SAE)
No injuries to the glans
16 (2.7%) incomplete cuts, which required completion using surgical scissors or a Mogen
Incomplete cuts were reduced to 1.9% after slight modification of the procedure

6. Conclusions
The Accucirc device is a safe alternative to the Mogen clamp which can result in injuries to the glans penis.
Restricting procedures to babies ≤30 days may reduce incomplete cuts
A complete Accucirc kit is an advantage for large scale implementation of EIMC programs
Because of safety and convenience, the AccuCirc should be considered for widespread adoption.
These results contribute evidence needed as countries transition from adult toward infant circumcision.

7. Acknowledgements We are grateful to the following:
All the mothers and babies who participated in the research
The Nyanza Reproductive Health Society
The University of Illinois at Chicago
The Division of AIDS, NIAID, NIH
Kenya Ministry of Health
The AccurCirc Study Team:
Irene Nyaboke Evelyne Adoyo
Valentine Pengo Caroline Moringa
Mary Auma Kentosse Gutu
Simon Were Jared Wadeya
Erick Okelo Mildred Adhiambo
Stella Adhiambo Millicent Ogosi