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American Journal of Epidemiology Advance Access originally published online on September 21, 2005
American Journal of Epidemiology 2005 162(9):907-916; doi:10.1093/aje/kwi284
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

Chlamydia trachomatis Infection in Female Partners of Circumcised and Uncircumcised Adult Men

Xavier Castellsagué1, Rosanna W. Peeling2, Silvia Franceschi3, Silvia de Sanjosé1, Jennifer S. Smith4, Ginesa Albero1, Mireia Díaz1, Rolando Herrero5, Nubia Muñoz1, F. Xavier Bosch1 for the IARC Multicenter Cervical Cancer Study Group

1 Cancer Epidemiology and Registration Unit, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
2 National Laboratory for Sexually Transmitted Diseases, Health Canada, Winnipeg, Canada
3 Epidemiology and Biology Cluster, International Agency for Research on Cancer, Lyon, France
4 Department of Epidemiology, University of North Carolina, Chapel Hill, NC
5 Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), San José, Costa Rica

Reprint requests to Dr. Xavier Castellsagué, Cancer Epidemiology and Registration Unit, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia, Gran via s/n, km 2.7, E-08907 L'Hospitalet de Llobregat, Barcelona, Spain (e-mail: xcastellsague{at}ico.scs.es).

Male circumcision has been shown to reduce the risk of acquiring and transmitting a number of venereal infections. However, little is known about the association between male circumcision and the risk of Chlamydia trachomatis infection in the female partner. The authors pooled data on 305 adult couples enrolled as controls in one of five case-control studies of invasive cervical cancer conducted in Thailand, the Philippines, Brazil, Colombia, and Spain between 1985 and 1997. Women provided blood samples for C. trachomatis and Chlamydia pneumoniae antibody detection; a type-specific microfluorescence assay was used. Multivariate odds ratios were computed for the association between male circumcision status and chlamydial seropositivity in women. Compared with women with uncircumcised partners, those with circumcised partners had a 5.6-fold reduced risk of testing seropositive for C. trachomatis (82% reduction; odds ratio = 0.18, 95% confidence interval: 0.05, 0.58). The inverse association was also observed after restricting the analysis to monogamous women and their only male partners (odds ratio = 0.21, 95% confidence interval: 0.06, 0.72). In contrast, seropositivity to C. pneumoniae, a non-sexually-transmitted infection, was not significantly related to circumcision status of the male partner. These findings suggest that male circumcision could reduce the risk of C. trachomatis infection in female sexual partners.

Chlamydia pneumoniae; Chlamydia trachomatis; circumcision; men; sexual behavior; sexually transmitted diseases

Abbreviations: CI, confidence interval; HPV, human papillomavirus; MIF, microimmunofluorescence; OR, odds ratio


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