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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Male circumcision for the prevention of HSV-2 and HPV infections and syphilis
New England Journal of Medicine, Volume 360, No. 13, Year 2009
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Description
Background Male circumcision significantly reduced the incidence of human immunodeficiency virus(HIV) infection among men in three clinical trials. We assessed the efficacy of male circumcision for the prevention of herpes simplex virus type 2(HSV-2) and human papillomavirus(HPV) infections and syphilis in HIV-negative adolescent boys and men. Methods We enrolled 5534 HIV-negative, uncircumcised male subjects between the ages of 15 and 49 years in two trials of male circumcision for the prevention of HIV and other sexually transmitted infections. Of these subjects, 3393(61.3%) were HSV-2-seronegative at enrollment. Of the seronegative subjects, 1684 had been randomly assigned to undergo immediate circumcision(intervention group) and 1709 to undergo circumcision after 24 months(control group). At baseline and at 6, 12, and 24 months, we tested subjects for HSV-2 and HIV infection and syphilis, along with performing physical examinations and conducting interviews. In addition, we evaluated a subgroup of subjects for HPV infection at baseline and at 24 months. Results At 24 months, the cumulative probability of HSV-2 seroconversion was 7.8% in the intervention group and 10.3% in the control group(adjusted hazard ratio in the intervention group, 0.72; 95% confidence interval [CI], 0.56 to 0.92; P=0.008). The prevalence of high-risk HPV genotypes was 18.0% in the intervention group and 27.9% in the control group(adjusted risk ratio, 0.65; 95% CI, 0.46 to 0.90; P = 0.009). However, no significant difference between the two study groups was observed in the incidence of syphilis(adjusted hazard ratio, 1.10; 95% CI, 0.75 to 1.65; P = 0.44). Conclusions In addition to decreasing the incidence of HIV infection, male circumcision significantly reduced the incidence of HSV-2 infection and the prevalence of HPV infection, findings that underscore the potential public health benefits of the procedure.(ClinicalTrials.gov numbers, NCT00425984 and NCT00124878.) Copyright © 2009 Massachusetts Medical Society.
Authors & Co-Authors
Tobian, Aaron A.R.
Uganda, Kampala
Departments of Pathology
Serwadda, David Musoke
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Uganda, Kampala
Makerere University
Quinn, Thomas Charles
Uganda, Kampala
Medicine
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Kigozi, Godfrey G.
Uganda, Kalisizo
Rakai Health Sciences Program
Gravitt, Patti E.
Uganda, Kampala
School of Medicine
Laeyendecker, Oliver B.
Uganda, Kampala
Medicine
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Charvat, Blake
Uganda, Kampala
Population
Ssempijja, Victor
Uganda, Kalisizo
Rakai Health Sciences Program
Riedesel, Melissa A.
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Oliver, Amy E.
Uganda, Kampala
Medicine
Nowak, Rebecca G.
Uganda, Kampala
School of Medicine
Moulton, Lawrence H.
Uganda, Kampala
International Health and Biostatistics
Chen, Michael Z.
Uganda, Kampala
Population
Reynolds, Steven James
Uganda, Kampala
Medicine
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Wawer, Maria J.
Uganda, Kampala
Population
Gray, Ronald H.
Uganda, Kampala
Population
Statistics
Citations: 497
Authors: 16
Affiliations: 9
Identifiers
Doi:
10.1056/NEJMoa0802556
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Cancer
Environmental
Infectious Diseases
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Participants Gender
Male