title: Male circumcision and Mycoplasma genitalium infection in female partners: a randomised trial in Rakai, Uganda.
abstract: OBJECTIVE
  Previous randomised trial data have demonstrated that male circumcision reduces Mycoplasma genitalium prevalence in men. We assessed whether male circumcision also reduces M genitalium infection in female partners of circumcised men.
  
  
  METHODS
  HIV-negative men were enrolled and randomised to either male circumcision or control. Female partners of male trial participants from the intervention (n=437) and control (n=394) arms provided interview information and self-collected vaginal swabs that were tested for M genitalium by APTIMA transcription-mediated amplification-based assay. Prevalence risk ratios (PRR) and 95% CI of M genitalium prevalence in intervention versus control group were estimated using Poisson regression. Analysis was by intention-to-treat. An as-treated analysis was conducted to account for study-group crossovers.
  
  
  RESULTS
  Male and female partner enrolment sociodemographic characteristics, sexual behaviours, and symptoms of sexually transmitted infections were similar between study arms. Female M genitalium prevalence at year 2 was 3.2% (14/437) in the intervention arm and 3.6% (14/394) in the control arm (PRR=0.90, 95% CI 0.43 to 1.89, p=0.78). In an as-treated analysis, the prevalence of M genitalium was 3.4% in female partners of circumcised men and 3.3% in female partners of uncircumcised men (PRR=1.01, 95% CI 0.48 to 2.12, p=0.97).
  
  
  CONCLUSIONS
  Contrary to findings in men, male circumcision did not affect M genitalium infection in female partners.
authors.affiliation: Department of Pathology, School of Medicine, Johns Hopkins University, , Baltimore, Maryland, USA.
authors.forename: Aaron A R
authors.initials: AA
authors.lastname: Tobian
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gaydos
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: Nicole
authors.initials: N
authors.lastname: Quinn
authors.forename: Mary K
authors.initials: MK
authors.lastname: Grabowski
authors.forename: Richard
authors.initials: R
authors.lastname: Musoke
authors.forename: Anthony
authors.initials: A
authors.lastname: Ndyanabo
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Wawer
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
mesh_terms: D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009175:Mycoplasma Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D045704:Mycoplasma genitalium / Q000302:isolation & purification*; D016012:Poisson Distribution; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D014454:Uganda / Q000453:epidemiology; D014621:Vagina / Q000382:microbiology*
keywords: Circumcision; Epidemiology (Clinical); Mycoplasma