Herpes Simplex Virus Type 2 in Women

As described for HPV, a history of sexual intercourse with an uncircumcised man (ever) was reported in 2003 to be a risk factor for herpes simplex virus type 2 (HSV-2) infection in women [Cherpes et al., 2003]. After multivariate logistic regression analysis, odds ratio was 2.2 (95% CI 1.4-3.6) [Cherpes et al., 2003]. This study was conducted in Pittsburgh, Pennsylvania amongst 1,207 women aged 18-30 years whose overall HSV-2 seroprevalence rate was 25%.

A study in Uganda found no difference, however, although most women had been infected with HSV-2 prior to commencement of the trial in which half the men had been randomized to receive circumcision and the other half had not, meaning that HSV-2 detected in swabs from these women represented mostly reactivation of an existing infection [Brankin et al., 2009].

HSV-2 prevalence was lower in 9 countries in which MC prevalence was >80% than it was in 10 countries in which MC was < 20% (30.1% vs. 42.9%, respectively; P >0.05) [Drain et al. 2006]. A study in India found an HSV-2 prevalence of 1.7% among women with circumcised spouses compared with 9.2% among women with uncircumcised spouses (OR = 5.7; 95% CI 1.4–23.4; P=0.01) [Borkakoty et al., 2010]. Similarly, a South African study of 4,766 women aged 15–49 years found that having a circumcised male partner was associated with lower HSV-2 prevalence in both younger women (49% vs. 62%; P < 0.01) and older women (83% vs. 86%; P=0.04) [Davis et al., 2017]. In that study, older women with circumcised male partners were less likely to have ever had an STI (7% vs. 11%; P<0.01).

Among 8,953 women in Kenya, those with circumcised partners had an HSV-2 prevalence of 39.4% compared to 77.4% in women with uncircumcised partners (P<0.001) [Mugo et al., 2011]. Risk of HSV-2 infection was 7.5 times higher among HIV-positive vs. HIV-negative women in that study. However, a study involving 14 sites in 7 sub-Saharan African countries found that MC provided negligible protection against HSV-2 infection among female partners (PRR = 0.94; P=0.49) [Mujugira et al., 2011].

A nonsignificant 15% risk reduction was found in the female partners of 368 circumcised men in a RCT in Uganda [Tobian et al., 2012]. In a Kenyan study, there was no difference in HSV-2-related genital ulcers between 14 women with circumcised and 14 women with uncircumcised partners [Mehta et al., 2017].
In summary, there is evidence from large observational studies, but not from trial data and some other studies, to suggest that male circumcision may reduce HSV-2 infection and prevalence in women. For more see systematic reviews [Grund et al., 2017; Morris et al., 2019b].



Chlamydia in women.

Circumcision Info

What is circumcision?
Who in the world gets circumised?
The circumcision debate.
Circumcision history and recent trends.
Position statements by national pediatric bodies.
Why the foreskin increases infection risk.
Circumcision - 'shapshot' of health benefits + reviews.
Different specialists see different things.
Circumcision - benefits outweigh the risks.
Pain and memory.
Penile hygiene.
What motivates parents to baby boy circumcision.
Rates of circumcision.
Physical problems.
Inflammatory dermatoses.
Urinary tract infections.
Sexually transmitted infections.
Cancer of the penis.
Prostate cancer.
Cervical cancer in female partners of uncircumcised men.
Breast cancer in female partners of uncircumcised men.
Herpes simplex type 2 virus in women.
Chlamydia in women.
Trichomonas in women.
Bacterial vaginosis in women.
HIV: the AIDS virus.
Circumcision Socio-sexual aspects.
Circumcision - sensitivity, sensation & sexual function.
Circumcision - societal class distinction.
Circumcision prevents infibulation.
Circumcision procedure.
Circumcision & Anesthesia.
Cost of the Circumcision procedure.
Cost benefit of Circumcision.
Circumcision - how do I find someone to do it?.
Circumcision - whose responsibility?...legal
Risks in infants.
Circumcision - risks in adults & older boys.
Circumcision - breastfeeding outcomes and cognitive ability.
Circumcision, does it affect penis length?
Circumcision - why are human males born with a foreskin?
Circumcision - best not to delay til later.
Circumcision - what caused many cultures to ritually remove the foreskin?
In Alphabetical Order
(A – I)(J – R)(S – Z)
Brochures, circumcision information guide.
Anti Circumcision
Anti-circumcision lobby groups.
Links & Resources
Circumcision websites & online discussion groups.
BOOK: "In Favour of Circumcision".
About the Author - Professor Emeritus Brian J. Morris.
Adult circumcision stories - testimonials and more.
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