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Male circumcision and Mycoplasma genitalium infection in female partners: a randomised trial in Rakai, Uganda
  1. Aaron A R Tobian1,2,
  2. Charlotte Gaydos3,
  3. Ronald H Gray2,4,
  4. Godfrey Kigozi2,
  5. David Serwadda2,5,
  6. Nicole Quinn3,
  7. Mary K Grabowski4,
  8. Richard Musoke2,
  9. Anthony Ndyanabo2,
  10. Fred Nalugoda2,
  11. Maria J Wawer2,4,
  12. Thomas C Quinn3,6
  1. 1Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Rakai Health Sciences Program, Entebbe, Uganda
  3. 3Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  5. 5School of Public Health, Makerere University, Kampala, Uganda
  6. 6Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Dr Aaron Tobian, Department of Pathology, Johns Hopkins University, Carnegie 437, 600 N. Wolfe St, Baltimore, MD 21287, USA; atobian1{at}jhmi.edu

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.

  • Circumcision
  • Mycoplasma
  • Epidemiology (Clinical)

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