Medical male circumcision and herpes simplex virus 2 acquisition: posttrial surveillance in Kisumu, Kenya.
Open accessAbstract
BACKGROUND: We estimated the 72-month efficacy of medical male circumcision (MMC) against herpes simplex virus 2 (HSV-2) incidence among men in the Kisumu MMC randomized trial. METHODS: From 2002 to 2005, 2784 men aged 18-24 were enrolled and randomized 1:1 to immediate circumcision or control. Cox proportional hazards regression incorporating stabilized inverse probability of treatment and censoring weights generated through marginal structural modeling was used to estimate the efficacy of MMC on HSV-2 risk. Conventional conditional Cox regression identified multivariable risks for HSV-2 seroconversion. RESULTS: Among 2044 HSV-2 seronegative men at baseline, the cumulative 72-month HSV-2 incidence was 33.5% (32.7% among circumcised men, 34.6% among uncircumcised men). In weight-adjusted Cox regression, the hazard ratio was 0.88 (95% confidence interval, .77-1.10). In multivariable analyses, risks for HSV-2 included human immunodeficiency virus (HIV) infection, genital ulcer disease (GUD), penile epithelial trauma, multiple recent sex partners, and being married /cohabiting. CONCLUSIONS: MMC had no effect on acquisition of HSV-2 during 72 months of follow-up. The temporal sequence and limited correlation between HSV-2, GUD, and penile epithelial trauma suggests that these are distinct phenomena rather than misclassification of HSV-2 symptoms. Determining the etiology of non-sexually transmitted infection GUD and penile epithelial trauma is needed, as both are commonly occurring risks for HSV-2 and HIV acquisition. CLINICAL TRIALS REGISTRATION: NCT0005937.
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MMC can be associated with decreased risk for HSV-2 acquisition among adult heterosexual men and with decreased risk for HSV-2 transmission from male to female partners.
“These data indicate that MMC can be associated with decreased risk for HSV-2 acquisition among adult heterosexual men and with decreased risk for HSV-2 transmission from male to female partners.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [490]
The Introduction reports that Ugandan and South African trials found reduced HSV-2 acquisition in men after circumcision. However, this paper’s own Results and Discussion report no protective effect in the Kisumu cohort, and our copy does not address HSV-2 transmission from men to female partners. (LLM, conf=0.85)
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Research works printed but not linked: 1
- Mehta SD, Moses S, Parker CB, Agot K, Maclean I, Bailey RC. Circum- cision status and incident HSV-2 infection, genital ulcer disease, and HIV infection. AIDS 2012; 26:1141-9.
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Sexually Transmitted Infections Treatment Guidelines, 2021
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- Authors
- Mehta, S. D., Moses, S., Agot, K., Maclean, I., Odoyo-June, E., Li, H., & Bailey, R. C.
- Affiliations
- University of Illinois Chicago (US)
- University of Manitoba (CA)
- Impact Research and Development Organization (KE)
- Corresponding author
- Mehta, S. D.
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-07-30
- Volume
- 208
- Issue
- 11
- Pages
- 1869-1876
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC3814838
- OpenAlex
- W2131085789
- Cited by
- 26
- References
- 30
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 4 · 2014: 1
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Chicago Developmental Center for AIDS Research (P30 AI 082151)
- National Institutes of Health
- Center for AIDS Research, University of Washington
- District of Columbia Developmental Center for AIDS Research
- Canadian Institutes of Health Research (HCT 44180)
- National Institute of Allergy and Infectious Diseases (U01AI050440, AI50440, P30AI082151)
- Topics
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Female Genital Mutilation/Cutting Issues
- Keywords
- medical male circumcision, herpes simplex virus type 2, HSV-2 incidence, HIV infection, genital ulcer disease, sexual partners
- MeSH terms
- Adolescent, Circumcision, Male, Follow-Up Studies, Genital Diseases, Male, Herpes Genitalis, Humans, Kenya, Male, Risk, Sexual Behavior, Sexual Partners, HIV Infections, Incidence, Multivariate Analysis, Logistic Models, Proportional Hazards Models, Treatment Outcome, Marital Status, Herpesvirus 2, Human, Young Adult
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