title: The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda.
abstract: OBJECTIVE
  The objective of the study was to assess effects of male circumcision on female genital symptoms and vaginal infections.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Male circumcision reduces the risk of ulceration, trichomonas, and BV in female partners.
authors.affiliation: Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. rgray@jhsph.edu
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Frederick
authors.initials: F
authors.lastname: Makumbi
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.forename: Stephen
authors.initials: S
authors.lastname: Watya
authors.forename: Laurence
authors.initials: L
authors.lastname: Moulton
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: Chen
authors.forename: Nelson K
authors.initials: NK
authors.lastname: Sewankambo
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.forename: Victor
authors.initials: V
authors.lastname: Sempijja
authors.forename: Tom
authors.initials: T
authors.lastname: Lutalo
authors.forename: Joseph
authors.initials: J
authors.lastname: Kagayii
authors.forename: Fred
authors.initials: F
authors.lastname: Wabwire-Mangen
authors.forename: Renée
authors.initials: R
authors.lastname: Ridzon
authors.forename: Melanie
authors.initials: M
authors.lastname: Bacon
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Wawer
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002944:Circumcision, Male; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D014247:Trichomonas Vaginitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014454:Uganda / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult