BACKGROUND: Bacterial vaginosis (BV) is common and has been associated with increased HIV-1 susceptibility. The objective of this study was to identify risk factors for BV in African women at high risk for acquiring HIV-1. METHODS: We conducted a prospective study among 151 HIV-1-seronegative Kenyan female sex workers. Nonpregnant women were eligible if they did not have symptoms of abnormal vaginal itching or discharge at the time of enrollment. At monthly follow-up, a vaginal examination and laboratory testing for genital tract infections were performed. Multivariate Andersen-Gill proportional hazards analysis was used to identify correlates of BV. RESULTS: Participants completed a median of 378 (interquartile range 350-412) days of follow-up. Compared with women reporting no vaginal washing, those who reported vaginal washing 1 to 14 [adjusted hazard ratio (aHR) 1.29, 95% confidence interval (CI) 0.88-1.89], 15 to 28 (aHR 1.60, 95% CI 0.98-2.61), and >28 times/wk (aHR 2.39, 95% CI 1.35-4.23) were at increased risk of BV. Higher BV incidence was also associated with the use of cloth for intravaginal cleansing (aHR 1.48, 95% CI 1.06-2.08) and with recent unprotected intercourse (aHR 1.75, 95% CI 1.47-2.08). Women using depot medroxyprogesterone acetate contraception were at lower risk for BV (aHR 0.59, 95% CI 0.48-0.73). CONCLUSIONS: Vaginal washing and unprotected intercourse were associated with increased risk of BV. These findings could help to inform the development of novel vaginal health approaches for HIV-1 risk reduction in women.
BACKGROUND: Bacterial vaginosis (BV) is common and has been associated with increased HIV-1 susceptibility. The objective of this study was to identify risk factors for BV in African women at high risk for acquiring HIV-1. METHODS: We conducted a prospective study among 151 HIV-1-seronegative Kenyan female sex workers. Nonpregnant women were eligible if they did not have symptoms of abnormal vaginal itching or discharge at the time of enrollment. At monthly follow-up, a vaginal examination and laboratory testing for genital tract infections were performed. Multivariate Andersen-Gill proportional hazards analysis was used to identify correlates of BV. RESULTS:Participants completed a median of 378 (interquartile range 350-412) days of follow-up. Compared with women reporting no vaginal washing, those who reported vaginal washing 1 to 14 [adjusted hazard ratio (aHR) 1.29, 95% confidence interval (CI) 0.88-1.89], 15 to 28 (aHR 1.60, 95% CI 0.98-2.61), and >28 times/wk (aHR 2.39, 95% CI 1.35-4.23) were at increased risk of BV. Higher BV incidence was also associated with the use of cloth for intravaginal cleansing (aHR 1.48, 95% CI 1.06-2.08) and with recent unprotected intercourse (aHR 1.75, 95% CI 1.47-2.08). Women using depot medroxyprogesterone acetate contraception were at lower risk for BV (aHR 0.59, 95% CI 0.48-0.73). CONCLUSIONS: Vaginal washing and unprotected intercourse were associated with increased risk of BV. These findings could help to inform the development of novel vaginal health approaches for HIV-1 risk reduction in women.
Authors: Margaret Riggs; Mark Klebanoff; Tonja Nansel; Jun Zhang; Jane Schwebke; William Andrews Journal: Sex Transm Dis Date: 2007-12 Impact factor: 2.830
Authors: H L Martin; B A Richardson; P M Nyange; L Lavreys; S L Hillier; B Chohan; K Mandaliya; J O Ndinya-Achola; J Bwayo; J Kreiss Journal: J Infect Dis Date: 1999-12 Impact factor: 5.226
Authors: J M Baeten; P M Nyange; B A Richardson; L Lavreys; B Chohan; H L Martin; K Mandaliya; J O Ndinya-Achola; J J Bwayo; J K Kreiss Journal: Am J Obstet Gynecol Date: 2001-08 Impact factor: 8.661
Authors: Harold C Wiesenfeld; Sharon L Hillier; Marijane A Krohn; Daniel V Landers; Richard L Sweet Journal: Clin Infect Dis Date: 2003-02-07 Impact factor: 9.079
Authors: Alison C Roxby; David N Fredricks; Katherine Odem-Davis; Kristjana Ásbjörnsdóttir; Linnet Masese; Tina L Fiedler; Stephen De Rosa; Walter Jaoko; James N Kiarie; Julie Overbaugh; R Scott McClelland Journal: J Acquir Immune Defic Syndr Date: 2016-04-01 Impact factor: 3.731
Authors: Michelle C Sabo; Barbra A Richardson; Ludo Lavreys; Harold L Martin; Walter Jaoko; Kishorchandra Mandaliya; Jared M Baeten; Julie Overbaugh; R Scott McClelland Journal: AIDS Date: 2019-06-01 Impact factor: 4.177
Authors: Caroline Mitchell; Lisa E Manhart; Katherine K Thomas; Kathy Agnew; Jeanne M Marrazzo Journal: Sex Transm Dis Date: 2011-12 Impact factor: 2.830
Authors: R Scott McClelland; Jairam R Lingappa; Sujatha Srinivasan; John Kinuthia; Grace C John-Stewart; Walter Jaoko; Barbra A Richardson; Krista Yuhas; Tina L Fiedler; Kishorchandra N Mandaliya; Matthew M Munch; Nelly R Mugo; Craig R Cohen; Jared M Baeten; Connie Celum; Julie Overbaugh; David N Fredricks Journal: Lancet Infect Dis Date: 2018-01-26 Impact factor: 25.071
Authors: Erica M Lokken; Barbra A Richardson; John Kinuthia; Khamis Mwinyikai; Amina Abdalla; Walter Jaoko; Kishorchandra Mandaliya; Juma Shafi; R Scott McClelland Journal: Sex Transm Dis Date: 2019-01 Impact factor: 2.830
Authors: Jeanne M Marrazzo; Katherine K Thomas; Tina L Fiedler; Kathleen Ringwood; David N Fredricks Journal: PLoS One Date: 2010-06-15 Impact factor: 3.240