title: The effect of medical male circumcision on urogenital Mycoplasma genitalium among men in Kisumu, Kenya.
abstract: BACKGROUND
  We determined the prevalence of urethral Mycoplasma genitalium (MG) infection and whether infection was associated with circumcision status among men enrolled in the randomized trial of medical male circumcision to prevent HIV acquisition in Kisumu, Kenya.
  
  
  METHODS
  MG and Trichomonas vaginalis were detected in first void urine by APTIMA transcription-mediated amplification assay. first void urine and urethral swabs were assessed for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) by polymerase chain reaction assay. Herpes simplex virus type 2 antibodies were detected by IgG ELISA. Multivariable logistic regression identified factors associated with MG infection.
  
  
  RESULTS
  Specimens were collected between July and September 2010, and 52 (9.9%; 95% confidence interval [CI]: 7.3%-12.4%) MG infections were detected among 526 men. N. gonorrhoeae and T. vaginalis were not associated with MG. CT coinfection was 5.8% in MG-infected men, and 0.8% among MG-uninfected men (P = 0.02). MG infection was predominantly asymptomatic (98%). The prevalence of MG was 13.4% in uncircumcised men versus 8.2% in circumcised men (P = 0.06). Being circumcised nearly halved the odds of MG (adjusted odds ratio [aQR] = 0.54; 95% CI: 0.29-0.99), adjusted for other variables significant at the P < 0.05 level: herpes simplex virus type 2 infection (aOR = 2.05; 95% CI: 1.05-4.00), CT infection (aOR = 2.69; 95% CI: 1.44-5.02), and washing the penis ≤1 hour after sex (aOR = 0.47; 95% CI: 0.24-0.95).
  
  
  CONCLUSIONS
  MG infection was reduced among men who were circumcised, adding to the benefits of male circumcision in preventing several sexually transmitted infections.
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Chicago, IL, USA. supriyad@uic.edu
authors.forename: Supriya D
authors.initials: SD
authors.lastname: Mehta
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gaydos
authors.forename: Ian
authors.initials: I
authors.lastname: Maclean
authors.forename: Elijah
authors.initials: E
authors.lastname: Odoyo-June
authors.forename: Stephen
authors.initials: S
authors.lastname: Moses
authors.forename: Lawrence
authors.initials: L
authors.lastname: Agunda
authors.forename: Nicole
authors.initials: N
authors.lastname: Quinn
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control; D002944:Circumcision, Male; D060085:Coinfection / Q000453:epidemiology / Q000517:prevention & control; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000453:epidemiology; D006558:Herpes Genitalis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009175:Mycoplasma Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D045704:Mycoplasma genitalium / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D014526:Urethritis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D055815:Young Adult