The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda.
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.
Gray
Ronald H
RH
Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. rgray@jhsph.edu
Kigozi
Godfrey
G
Serwadda
David
D
Makumbi
Frederick
F
Nalugoda
Fred
F
Watya
Stephen
S
Moulton
Laurence
L
Chen
Michael Z
MZ
Sewankambo
Nelson K
NK
Kiwanuka
Noah
N
Sempijja
Victor
V
Lutalo
Tom
T
Kagayii
Joseph
J
Wabwire-Mangen
Fred
F
Ridzon
Renée
R
Bacon
Melanie
M
Wawer
Maria J
MJ
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