Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Aetiology of genital ulcer disease in female partners of male participants in a circumcision trial in Uganda

TitleAetiology of genital ulcer disease in female partners of male participants in a circumcision trial in Uganda
Publication TypeJournal Article
Year of Publication2009
AuthorsBrankin, AE, Tobian, AA, Laeyendecker, O, Suntoke, TR, Kizza, A, Mpoza, B, Kigozi, G, Nalugoda, F, Iga, B, Chen, MZ, Gray, RH, Wawer, MJ, Quinn, TC, Reynolds, SJ
JournalInternational Journal of STD & AIDS
Date PublishedSep
ISBN Number0956-4624; 0956-4624
Accession Number19710342
KeywordsCircumcision, Male, Female, Genital Diseases, Female/etiology, Herpesvirus 2, Human/isolation & purification, HIV Seronegativity, Humans, Male, Sexual Partners, Uganda, Ulcer

HIV acquisition is associated with herpes simplex virus type 2 (HSV-2) infection and genital ulcer disease (GUD). Three randomized control trials demonstrated that male circumcision significantly decreases HIV, HSV-2, human papillomavirus and self-reported GUD among men. GUD is also decreased among female partners of circumcised men, but it is unknown whether male circumcision status affects GUD pathogens in female partners. For the evaluation of GUD aetiology, two separate multiplex assays were performed to detect Haemophilus ducreyi, Treponema pallidum, HSV-1 and HSV-2. Of all the female GUD swabs evaluated, 67.5% had an aetiology identified, and HSV-2 was the primary pathogen detected (96.3%). However, there was no difference in the proportion of ulcers due to HSV-2 or other pathogens between female partners of circumcised men (11/15, 73.3%) compared with uncircumcised men (15/25, 60.0%, P = 0.39). The seroprevalence of HSV-2 is high in this population and therefore most of the detected HSV-2 infections represent reactivation. Since GUD is associated with HIV acquisition and one-third of GUD in this study did not have an aetiological agent identified, further research is needed to better understand the aetiology of GUD in Africa, and its relationship to circumcision and HIV infection.