The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda

Am J Obstet Gynecol. 2009 Jan;200(1):42.e1-7. doi: 10.1016/j.ajog.2008.07.069. Epub 2008 Oct 30.

Abstract

Objective: The objective of the study was to assess effects of male circumcision on female genital symptoms and vaginal infections.

Study design: Human immunodeficiency virus (HIV)-negative men enrolled in a trial were randomized to immediate or delayed circumcision (control arm). Genital symptoms, bacterial vaginosis (BV), and trichomonas were assessed in HIV-negative wives of married participants. Adjusted prevalence risk ratios (adjPRR) and 95% confidence intervals (CIs) were assessed by multivariable log-binomial regression, intent-to-treat analyses.

Results: A total of 783 wives of control and 825 wives of intervention arm men were comparable at enrollment. BV at enrollment was higher in control (38.3%) than intervention arm spouses (30.5%, P = .001). At 1 year follow-up, intervention arm wives reported lower rates of genital ulceration (adjPRR, 0.78; 95% CI, 0.63-0.97), but there were no differences in vaginal discharge or dysuria. The risk of trichomonas was reduced in intervention arm wives (adjPRR, 0.52; 95% CI, 0.05-0.98), as were the risks of any BV (adjPRR, 0.60; 95% CI, 0.38-0.94) and severe BV (prevalence risk ratios, 0.39; 95% CI, 0.24-0.64).

Conclusion: Male circumcision reduces the risk of ulceration, trichomonas, and BV in female partners.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Circumcision, Male*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Trichomonas Vaginitis / diagnosis
  • Trichomonas Vaginitis / epidemiology*
  • Trichomonas Vaginitis / microbiology
  • Trichomonas vaginalis / isolation & purification
  • Uganda / epidemiology
  • Vaginosis, Bacterial / diagnosis
  • Vaginosis, Bacterial / epidemiology*
  • Vaginosis, Bacterial / microbiology
  • Young Adult