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Background & Methods

Male circumcision and the incidence of syphilis acquisition among male and female partners of HIV-1 serodiscordant heterosexual African couples: a prospective study

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Background & Methods

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  1. Male circumcision and the incidence of syphilis acquisition among male and female partners of HIV-1 serodiscordant heterosexual African couples: a prospective study Jillian Pintye1, Jared Baeten1, Lisa Manhart1, Connie Celum1, Allan Ronald2,3, Nelly Mugo1,4, Andrew Mujugira1, Craig Cohen4,5, Edwin Were6, Elizabeth Bukusi4,5, James Kiarie1,7, Renee Heffron1 For the Partners PrEP Study Team1University of Washington, 2University of Manitoba, 3Makerere University, 4 Kenya Medical Research Institute, 5University of California-San Francisco, 6Moi University, 7University of Nairobi Background & Methods • It is uncertain whether male circumcision (MC) reduces the risk of syphilis among men and women • Partners PrEP Study data (n=4,716) analyzed to assess association of MC with incident syphilis in men and women • RPR titer change of >4-fold with a Treponemapallidum–specific confirmatory result defined incident case • MC status determined by physical examination and analyzed as time-varying • 221 incident syphilis infections observed (99 in women, 122 in men) No conflicts of interest to disclose

  2. Incident Syphilis & Risk Reduction Incidence rate (per 100 person-years) 1Adjusted for age, sexual behavior, and plasma HIV-1 RNA levels of HIV-1 infected partner

  3. Limitations Implications • Annual assessment of syphilis and MC status • Absence of laboratory testing to link syphilis infections • MC associated with decreased risk of syphilis in men and women • MC may have benefits for syphilis prevention that expand its impact Acknowledgements We are grateful to the couples who participated in this studyUniversity of Washington Coordinating Center and Central Labs:  Connie Celum, Jared M. Baeten, Deborah Donnell, Robert W. Coombs, Lisa Frenkel, Craig W. Hendrix, JairamLingappa, M. Juliana McElrath. Site teams and partners: Kenneth Fife, Edwin Were (Eldoret, Kenya); Elioda Tumwesigye (Kabwohe, Uganda); Patrick Ndase, Elly Katabira(Jinja, Uganda); Elly Katabira, Allan Ronald (Kampala, Uganda); Elizabeth Bukusi, Craig Cohen (Kisumu, Kenya); Jonathan Wangisi, James Campbell, Jordan Tappero(Mbale, Uganda); James Kiarie, Carey Farquhar, Grace John-Stewart (Nairobi, Kenya); Nelly Rwamba Mugo(Thika, Kenya); James Campbell, Jordan Tappero, Jonathan Wangisi(Tororo, Uganda); DF/Net Research, Inc. (Data management); Contract Laboratory Services (Laboratory management); Gilead Sciences(Study drug donation) Funding was provided by the Bill and Melinda Gates Foundation (research grant OPP47674) and the National Institute of Child Health and Development (grants K99HD076679). Travel funds provided by the International AIDS Society

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