L Stewart Massad1, Elizabeth M Daubert2, Charlesnika T Evans3,4, Howard Minkoff5, Seble Kassaye6, Jodie Dionne-Odom7, Dominika Seidman8, Kerry Murphy9, Maria L Alcaide10, Adaora A Adimora11, Anandi N Sheth12, Elizabeth T Golub13, Audrey L French14, Kathleen M Weber2. 1. Department of Obstetrics & Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA. 2. Cook County Health/Hektoen Institute of Medicine, Chicago, Illinois, USA. 3. Department of Preventive Medicine, Center for Health Services and Outcomes Research, Northwestern University, Chicago, Illinois, USA. 4. VA Center of Innovation for Complex Chronic Healthcare, Hines, Illinois, USA. 5. Department of Obstetrics & Gynecology, Maimonides Medical Center, SUNY Downstate Health Sciences University, Brooklyn, New York, USA. 6. Department of Medicine, Georgetown University, Washington, District of Columbia, USA. 7. Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 8. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California, USA. 9. Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA. 10. Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA. 11. Department of Medicine, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 12. Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA. 13. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 14. Department of Medicine, Stroger Hospital of Cook County, Chicago, Illinois, USA.
Abstract
Background: Women with human immunodeficiency virus (HIV) often have bacterial vaginosis (BV). The goal of this analysis was to assess how BV prevalence changed over time and across U.S. regions in enrollment cohorts of the Women's Interagency HIV Study. Methods: In a multisite study, BV was diagnosed retrospectively when pH and two of three other Amsel criteria were met. Prevalence was determined across four recruitment waves: 1994-5, 2001-2, 2011-2, and 2013-5. Generalized estimating equation multivariable logistic regression models assessed changes in visit prevalence across waves after controlling for HIV disease severity and other risks. Results: Among 4,790 women (3,539 with HIV and 1,251 without HIV), BV was diagnosed at 7,870 (12%) of 64,444 visits. Baseline prevalence across enrollment waves was 15.0%-19.2%, but declined in all cohorts, with prevalence in the initial cohort falling to 3.9% in the 1994-5 cohort after up to 21 years of continuous observation. Prevalence varied within U.S. regions. HIV status was not associated with BV. Conclusion: BV prevalence decreased with time in study. Prevalence varied across sites, but was not uniformly increased or decreased in any U.S. region. Clinical Trials.gov identifier: NCT00000797.
Background: Women with human immunodeficiency virus (HIV) often have bacterial vaginosis (BV). The goal of this analysis was to assess how BV prevalence changed over time and across U.S. regions in enrollment cohorts of the Women's Interagency HIV Study. Methods: In a multisite study, BV was diagnosed retrospectively when pH and two of three other Amsel criteria were met. Prevalence was determined across four recruitment waves: 1994-5, 2001-2, 2011-2, and 2013-5. Generalized estimating equation multivariable logistic regression models assessed changes in visit prevalence across waves after controlling for HIV disease severity and other risks. Results: Among 4,790 women (3,539 with HIV and 1,251 without HIV), BV was diagnosed at 7,870 (12%) of 64,444 visits. Baseline prevalence across enrollment waves was 15.0%-19.2%, but declined in all cohorts, with prevalence in the initial cohort falling to 3.9% in the 1994-5 cohort after up to 21 years of continuous observation. Prevalence varied within U.S. regions. HIV status was not associated with BV. Conclusion: BV prevalence decreased with time in study. Prevalence varied across sites, but was not uniformly increased or decreased in any U.S. region. Clinical Trials.gov identifier: NCT00000797.
Entities:
Keywords:
Amsel criteria; bacterial vaginosis; human immunodeficiency virus infection in women
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