TY - JOUR
T1 - The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda
AU - Gray, Ronald H.
AU - Kigozi, Godfrey
AU - Serwadda, David
AU - Makumbi, Frederick
AU - Nalugoda, Fred
AU - Watya, Stephen
AU - Moulton, Laurence
AU - Chen, Michael Z.
AU - Sewankambo, Nelson K.
AU - Kiwanuka, Noah
AU - Sempijja, Victor
AU - Lutalo, Tom
AU - Kagayii, Joseph
AU - Wabwire-Mangen, Fred
AU - Ridzon, Renée
AU - Bacon, Melanie
AU - Wawer, Maria J.
N1 - Funding Information:
Enrollment of the HIV-negative male trial participants was funded by the National Institutes of Health, and the trial was registered ( ClinicalTrials.Gov number NCT00425984 ). The enrollment and follow-up of female partners of trial participants was funded by the Gates Foundation and is registered ( Clinical.Trials.Gov number NCT00124878 ).
Funding Information:
The laboratory component was supported in part by the Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health. We would like to acknowledge the members of the National Institutes of Health and Bill and Melinda Gates Foundation data safety monitoring boards, which monitored this trial, as well as the institutional review boards, which provided oversight (the Scientific and Ethics Committee of the Uganda Virus Research Institute, the Committee for Human Research at Johns Hopkins, and the Western Institutional Review Board). We also are grateful for the advice provided by the Rakai Community Advisory Board. Finally, we wish to express our gratitude to study participants whose commitment and cooperation made the study possible.
PY - 2009/1
Y1 - 2009/1
N2 - Objective: The objective of the study was to assess effects of male circumcision on female genital symptoms and vaginal infections. Study Design: Human immunodeficiency virus (HIV)-negative men enrolled in a trial were randomized to immediate or delayed circumcision (control arm). Genital symptoms, bacterial vaginosis (BV), and trichomonas were assessed in HIV-negative wives of married participants. Adjusted prevalence risk ratios (adjPRR) and 95% confidence intervals (CIs) were assessed by multivariable log-binomial regression, intent-to-treat analyses. Results: A total of 783 wives of control and 825 wives of intervention arm men were comparable at enrollment. BV at enrollment was higher in control (38.3%) than intervention arm spouses (30.5%, P = .001). At 1 year follow-up, intervention arm wives reported lower rates of genital ulceration (adjPRR, 0.78; 95% CI, 0.63-0.97), but there were no differences in vaginal discharge or dysuria. The risk of trichomonas was reduced in intervention arm wives (adjPRR, 0.52; 95% CI, 0.05-0.98), as were the risks of any BV (adjPRR, 0.60; 95% CI, 0.38-0.94) and severe BV (prevalence risk ratios, 0.39; 95% CI, 0.24-0.64). Conclusion: Male circumcision reduces the risk of ulceration, trichomonas, and BV in female partners.
AB - Objective: The objective of the study was to assess effects of male circumcision on female genital symptoms and vaginal infections. Study Design: Human immunodeficiency virus (HIV)-negative men enrolled in a trial were randomized to immediate or delayed circumcision (control arm). Genital symptoms, bacterial vaginosis (BV), and trichomonas were assessed in HIV-negative wives of married participants. Adjusted prevalence risk ratios (adjPRR) and 95% confidence intervals (CIs) were assessed by multivariable log-binomial regression, intent-to-treat analyses. Results: A total of 783 wives of control and 825 wives of intervention arm men were comparable at enrollment. BV at enrollment was higher in control (38.3%) than intervention arm spouses (30.5%, P = .001). At 1 year follow-up, intervention arm wives reported lower rates of genital ulceration (adjPRR, 0.78; 95% CI, 0.63-0.97), but there were no differences in vaginal discharge or dysuria. The risk of trichomonas was reduced in intervention arm wives (adjPRR, 0.52; 95% CI, 0.05-0.98), as were the risks of any BV (adjPRR, 0.60; 95% CI, 0.38-0.94) and severe BV (prevalence risk ratios, 0.39; 95% CI, 0.24-0.64). Conclusion: Male circumcision reduces the risk of ulceration, trichomonas, and BV in female partners.
KW - bacterial vaginosis
KW - female genital ulceration
KW - male circumcision
KW - trichomonas
KW - vaginal infections
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U2 - 10.1016/j.ajog.2008.07.069
DO - 10.1016/j.ajog.2008.07.069
M3 - Article
C2 - 18976733
AN - SCOPUS:58149090669
SN - 0002-9378
VL - 200
SP - 42.e1-42.e7
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 1
ER -