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Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis: observations in the aftermath of a randomised controlled trial for HIV prevention.
  1. Joelle Sobngwi -Tambekou
  1. INSERM U687, France
    1. Dirk Taljaard
    1. Progressus, South Africa
      1. Marthi Nieuwoudt
      1. NICD, South Africa
        1. Pascale Lissouba
        1. INSERM U687, France
          1. Adrian Puren
          1. NICD, South Africa
            1. Bertran Auvert (bertran.auvert{at}uvsq.fr)
            1. University of Versailles, France

              Abstract

              Objective: The objective of this study was to assess the association between male circumcision (MC) and Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) using data from a MC randomized controlled trial (RCT).

              Methods: We used data collected during the MC trial conducted in Orange Farm (South Africa) among men aged 18 to 24. 1767 urine samples collected during the final follow-up visit were analyzed using PCR. Prevalences of NG, CT and TV were assessed as a function of MC, using odds-ratios (OR) given by univariate and multivariate logistic regression.

              Results: In an intention-to-treat analysis, prevalences of NG, CT and TV among intervention and control groups were: 10.0% vs. 10.3% (OR = 0.97, p = 0.84), 2.1% vs. 3.6% (OR = 0.58, p = 0.065), and 1.7% vs. 3.1% (OR = 0.54, p = 0.062), respectively. The association between TV and MC 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 and AOR = 0.41, p = .030).

              Conclusions: This study demonstrates for the first time that MC reduces TV infection among men. This finding explains why women with circumcised partners are less at risk for TV infection than other women. The protective effect on TV is an additional argument to recommend MC in Africa where it is acceptable.

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