Assessing Odor Level when Using PrePex for XXXX Prevention: A Prospective, Randomized, Open Label, Blinded Assessor Trial to Improve Uptake of Male Circumcision.

@entity1 @entity1216 @entity645
The PrePex is a WHO--prequalified medical device for adult male circumcision for @entity645 prevention. The Government of Rwanda was the first country to implement the PrePex device and acts as the leading center of excellence providing training and formal guidelines. As part of the Government's efforts to improve PrePex implementation, it made efforts to improve the psychological acceptability of device by @entity1 , thus increasing uptake with VMMC in sub-Saharan Africa. Some @entity1 who underwent the PrePex procedure complained of foreskin odor while wearing the PrePex 3-7 days after it was placed. This complaint was identified as potential risk for uptake of the device. Researchers from Rwanda assumed there is a possible relation between the level of foreskin odor and @entity1 foreskin hygiene technique. The Government of Rwanda decided to investigate those assumptions in a scientific way and conduct a trial to test different hygiene-cleaning methods in order to increase the acceptability of PrePex and mitigate the odor concern. The main objective of the trial was to compare odor levels between three arms, having identical personal hygiene but different foreskin hygiene techniques using either clear water with soap during a daily shower, soapy water using a syringe, or @entity1216 using a syringe. One hundred and one subjects were enrolled to the trial and randomly allocated into three trial arms. Using @entity1216 solution daily almost completely eliminated odor, and was statistically significant more effective that the other two arms. The trial results suggest that odor from the foreskin, while wearing the PrePex device, could be related to the growth of anaerobic bacteria, which can be prevented by a @entity1216 cleaning method. This finding can be used to increase acceptability by @entity1 when considering PrePex as one of the leading methods for @entity645 prevention in VMMC programs.
