Gray Ronald H, Kigozi Godfrey, Serwadda David, Makumbi Frederick, Nalugoda Fred, Watya Stephen, Moulton Laurence, Chen Michael Z, Sewankambo Nelson K, Kiwanuka Noah, Sempijja Victor, Lutalo Tom, Kagayii Joseph, Wabwire-Mangen Fred, Ridzon Renée, Bacon Melanie, Wawer Maria J
Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Obstet Gynecol. 2009 Jan;200(1):42.e1-7. doi: 10.1016/j.ajog.2008.07.069. Epub 2008 Oct 30.
The objective of the study was to assess effects of male circumcision on female genital symptoms and vaginal infections.
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.
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).
Male circumcision reduces the risk of ulceration, trichomonas, and BV in female partners.
本研究的目的是评估男性包皮环切术对女性生殖器症状和阴道感染的影响。
参与一项试验的人类免疫缺陷病毒（HIV）阴性男性被随机分为立即包皮环切组或延迟包皮环切组（对照组）。对已婚参与者的HIV阴性妻子的生殖器症状、细菌性阴道病（BV）和滴虫病进行评估。通过多变量对数二项回归意向性分析评估调整后的患病率风险比（adjPRR）和95%置信区间（CI）。
对照组的783名妻子和干预组男性的825名妻子在入组时具有可比性。入组时，对照组的BV患病率（38.3%）高于干预组配偶（30.5%，P = 0.001）。在1年随访时，干预组妻子报告的生殖器溃疡发生率较低（adjPRR，0.78；95%CI，0.63 - 0.97），但在阴道分泌物或排尿困难方面没有差异。干预组妻子的滴虫病风险降低（adjPRR，0.52；95%CI，0.05 - 0.98），任何BV的风险（adjPRR，0.60；95%CI，0.38 - 0.94）和严重BV的风险（患病率风险比，0.39；95%CI，0.24 - 0.64）也降低。
男性包皮环切术可降低女性性伴侣发生溃疡、滴虫病和BV的风险。
