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Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links.
Ann Epidemiol. 2012 Mar; 22(3):213-20.AE

Abstract

PURPOSE

Interactions between bacterial vaginosis (BV) and inflammatory sexually transmitted infections, such as gonorrhea and chlamydial infection, are not well understood. Furthermore, evidence regarding the sexual transmission of BV is equivocal.

METHODS

We assessed associations between incident BV and incidences of gonorrhea and/or chlamydial infection ("gonorrhea/chlamydia"), as well as similarities in associations for the two processes, among 645 female patients at a sexually transmitted disease clinic in Alabama followed prospectively for 6 months from 1995 to 1998. We identified predictors of both incident BV and gonorrhea/chlamydia and used bivariate logistic regression to determine whether these predictors differed.

RESULTS

Participants completed 3188 monthly, follow-up visits. Several factors associated with incident BV involved sexual intercourse: young age (<16 years) at first intercourse (adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1-1.9), recent drug use during sex (aOR, 1.7; 95% CI, 1.2-2.5), prevalent trichomoniasis (aOR, 2.8; 95% CI, 1.7-4.6) and incident syphilis (aOR, 9.7; 95% CI, 1.9-48.4). Few statistical differences between potential factors for BV and gonorrhea/chlamydia emerged. BV appeared to precede the acquisition of gonorrhea/chlamydia (pairwise odds ratio, 1.6; 95% CI, 1.1-2.3), and vice versa (pairwise odds ratio, 2.4; 95% CI, 1.7-3.5).

CONCLUSIONS

Findings are consistent with a causal role of sexual behavior in the acquisition of BV and confirm that BV facilitates acquisition of gonorrhea/chlamydia and vice versa independently from other risk factors.

Authors+Show Affiliations

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA. mgallo@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22192490

Citation

Gallo, Maria F., et al. "Bacterial Vaginosis, Gonorrhea, and Chlamydial Infection Among Women Attending a Sexually Transmitted Disease Clinic: a Longitudinal Analysis of Possible Causal Links." Annals of Epidemiology, vol. 22, no. 3, 2012, pp. 213-20.
Gallo MF, Macaluso M, Warner L, et al. Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links. Ann Epidemiol. 2012;22(3):213-20.
Gallo, M. F., Macaluso, M., Warner, L., Fleenor, M. E., Hook, E. W., Brill, I., & Weaver, M. A. (2012). Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links. Annals of Epidemiology, 22(3), 213-20. https://doi.org/10.1016/j.annepidem.2011.11.005
Gallo MF, et al. Bacterial Vaginosis, Gonorrhea, and Chlamydial Infection Among Women Attending a Sexually Transmitted Disease Clinic: a Longitudinal Analysis of Possible Causal Links. Ann Epidemiol. 2012;22(3):213-20. PubMed PMID: 22192490.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links. AU - Gallo,Maria F, AU - Macaluso,Maurizio, AU - Warner,Lee, AU - Fleenor,Michael E, AU - Hook,Edward W,3rd AU - Brill,Ilene, AU - Weaver,Mark A, Y1 - 2011/12/20/ PY - 2011/08/15/received PY - 2011/11/23/revised PY - 2011/11/25/accepted PY - 2011/12/24/entrez PY - 2011/12/24/pubmed PY - 2012/6/12/medline SP - 213 EP - 20 JF - Annals of epidemiology JO - Ann Epidemiol VL - 22 IS - 3 N2 - PURPOSE: Interactions between bacterial vaginosis (BV) and inflammatory sexually transmitted infections, such as gonorrhea and chlamydial infection, are not well understood. Furthermore, evidence regarding the sexual transmission of BV is equivocal. METHODS: We assessed associations between incident BV and incidences of gonorrhea and/or chlamydial infection ("gonorrhea/chlamydia"), as well as similarities in associations for the two processes, among 645 female patients at a sexually transmitted disease clinic in Alabama followed prospectively for 6 months from 1995 to 1998. We identified predictors of both incident BV and gonorrhea/chlamydia and used bivariate logistic regression to determine whether these predictors differed. RESULTS: Participants completed 3188 monthly, follow-up visits. Several factors associated with incident BV involved sexual intercourse: young age (<16 years) at first intercourse (adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1-1.9), recent drug use during sex (aOR, 1.7; 95% CI, 1.2-2.5), prevalent trichomoniasis (aOR, 2.8; 95% CI, 1.7-4.6) and incident syphilis (aOR, 9.7; 95% CI, 1.9-48.4). Few statistical differences between potential factors for BV and gonorrhea/chlamydia emerged. BV appeared to precede the acquisition of gonorrhea/chlamydia (pairwise odds ratio, 1.6; 95% CI, 1.1-2.3), and vice versa (pairwise odds ratio, 2.4; 95% CI, 1.7-3.5). CONCLUSIONS: Findings are consistent with a causal role of sexual behavior in the acquisition of BV and confirm that BV facilitates acquisition of gonorrhea/chlamydia and vice versa independently from other risk factors. SN - 1873-2585 UR - https://www.unboundmedicine.com/medline/citation/22192490/Bacterial_vaginosis_gonorrhea_and_chlamydial_infection_among_women_attending_a_sexually_transmitted_disease_clinic:_a_longitudinal_analysis_of_possible_causal_links_ DB - PRIME DP - Unbound Medicine ER -