Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis: observations after a randomised controlled trial for HIV prevention.
OBJECTIVE
To assess the association between male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis using data from a male circumcision randomised controlled trial.


METHODS
We used data collected during the male circumcision trial conducted in Orange Farm (South Africa) among men aged 18-24 years. Altogether, 1767 urine samples collected during the final follow-up visit were analysed using PCR. Prevalence of N gonorrhoeae, C trachomatis and T vaginalis was assessed as a function of male circumcision using odds ratios (OR) given by univariate and multivariate logistic regression.


RESULTS
In an intention-to-treat analysis, prevalence of N gonorrhoeae, C trachomatis and T vaginalis among intervention and control groups were 10.0% versus 10.3% (OR 0.97; p = 0.84), 2.1% versus 3.6% (OR 0.58; p = 0.065) and 1.7% versus 3.1% (OR 0.54; p = 0.062), respectively. The association between T vaginalis and male circumcision remained borderline when controlling for age, ethnic group, number of lifetime partners, marital status, condom use and HIV status (AOR 0.48; p = 0.069). In the as-treated analysis, this association became significant (OR 0.49, p = 0.030; AOR 0.41, p = 0.030).


CONCLUSIONS
This study demonstrates for the first time that male circumcision reduces T vaginalis infection among men. This finding explains why women with circumcised partners are less at risk for T vaginalis infection than other women. The protective effect on T vaginalis is an additional argument to recommend male circumcision in Africa where it is acceptable.
Sobngwi-Tambekou
J
J
INSERM U687, Hôpital Paul Brousse, Villejuif, France.
Taljaard
D
D
Nieuwoudt
M
M
Lissouba
P
P
Puren
A
A
Auvert
B
B
D000293:Adolescent; D000328:Adult; D000818:Animals; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D016032:Randomized Controlled Trials as Topic; D013019:South Africa / Q000453:epidemiology; D014245:Trichomonas Infections / Q000453:epidemiology* / Q000517:prevention & control; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D055815:Young Adult