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

Ronald H. Gray, Godfrey Kigozi, David Serwadda, Frederick Makumbi, Fred Nalugoda, Stephen Watya, Laurence Moulton, Michael Z. Chen, Nelson K. Sewankambo, Noah Kiwanuka, Victor Sempijja, Tom Lutalo, Joseph Kagayii, Fred Wabwire-Mangen, Renée Ridzon, Melanie Bacon, Maria J. Wawer

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)42.e1-42.e7
JournalAmerican journal of obstetrics and gynecology
Volume200
Issue number1
DOIs
StatePublished - Jan 2009

Keywords

  • bacterial vaginosis
  • female genital ulceration
  • male circumcision
  • trichomonas
  • vaginal infections

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Gray, R. H., Kigozi, G., Serwadda, D., Makumbi, F., Nalugoda, F., Watya, S., Moulton, L., Chen, M. Z., Sewankambo, N. K., Kiwanuka, N., Sempijja, V., Lutalo, T., Kagayii, J., Wabwire-Mangen, F., Ridzon, R., Bacon, M., & Wawer, M. J. (2009). The effects of male circumcision on female partners' genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda. American journal of obstetrics and gynecology, 200(1), 42.e1-42.e7. https://doi.org/10.1016/j.ajog.2008.07.069