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Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV.
Clin Infect Dis. 2015 Apr 01; 60(7):1042-53.CI

Abstract

BACKGROUND

Female same-sex partnerships provide a unique opportunity to study the pathogenesis and transmissibility of bacterial vaginosis (BV) because it can be diagnosed in both members of the partnership. We conducted a nationwide community-enrolled cohort study of women who have sex with women, including women coenrolled with their regular female sexual partner (FSP), to investigate the BV incidence rate and factors associated with incident BV.

METHODS

Women who have sex with women, without prevalent BV in a cross-sectional study, were enrolled in a 24-month cohort study involving 3-monthly questionnaires and self-collected vaginal swabs that were scored by the Nugent method. We assessed the BV incidence rate per 100 woman-years (WY) and used univariate and multivariable Cox regression analysis to establish factors associated with BV acquisition.

RESULTS

Two hundred ninety-eight participants were enrolled in the cohort; 122 were coenrolled with their regular FSP. There were 51 incident cases of BV (rate, 9.75/100 WY; 95% confidence interval [CI], 7.41-12.83). Incident BV was associated with exposure to a new sexual partner (adjusted hazard ratio [AHR], 2.51; 95% CI, 1.30-4.82), a partner with BV symptoms (AHR, 3.99; 95% CI, 1.39-11.45), receptive oral sex (AHR, 3.52; 95% CI, 1.41-8.79), and onset of BV symptoms (AHR, 2.80; 95% CI, 1.39-5.61). Women coenrolled with their BV-negative partner had a greatly reduced risk of incident BV (AHR, 0.26; 95% CI, .11-.61), and high concordance of Nugent category (74%), which was predominantly normal vaginal flora throughout follow-up.

CONCLUSIONS

These data highlight the strong influence of sexual relationships and behaviors on BV acquisition and the vaginal microbiota. They provide epidemiological evidence to support exchange of vaginal bacterial species between women and the concept that BV is sexually transmitted.

Authors+Show Affiliations

Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria.Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria.The Kirby Institute, University of New South Wales, Darlinghurst.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria Central Clinical School, Monash University, Melbourne, Victoria, Australia.Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25516188

Citation

Vodstrcil, Lenka A., et al. "Incident Bacterial Vaginosis (BV) in Women Who Have Sex With Women Is Associated With Behaviors That Suggest Sexual Transmission of BV." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 60, no. 7, 2015, pp. 1042-53.
Vodstrcil LA, Walker SM, Hocking JS, et al. Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis. 2015;60(7):1042-53.
Vodstrcil, L. A., Walker, S. M., Hocking, J. S., Law, M., Forcey, D. S., Fehler, G., Bilardi, J. E., Chen, M. Y., Fethers, K. A., Fairley, C. K., & Bradshaw, C. S. (2015). Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 60(7), 1042-53. https://doi.org/10.1093/cid/ciu1130
Vodstrcil LA, et al. Incident Bacterial Vaginosis (BV) in Women Who Have Sex With Women Is Associated With Behaviors That Suggest Sexual Transmission of BV. Clin Infect Dis. 2015 Apr 1;60(7):1042-53. PubMed PMID: 25516188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. AU - Vodstrcil,Lenka A, AU - Walker,Sandra M, AU - Hocking,Jane S, AU - Law,Matthew, AU - Forcey,Dana S, AU - Fehler,Glenda, AU - Bilardi,Jade E, AU - Chen,Marcus Y, AU - Fethers,Katherine A, AU - Fairley,Christopher K, AU - Bradshaw,Catriona S, Y1 - 2014/12/16/ PY - 2014/12/18/entrez PY - 2014/12/18/pubmed PY - 2016/1/7/medline KW - bacterial vaginosis KW - lesbian KW - sexual behavior KW - sexual partner KW - women who have sex with women SP - 1042 EP - 53 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 60 IS - 7 N2 - BACKGROUND: Female same-sex partnerships provide a unique opportunity to study the pathogenesis and transmissibility of bacterial vaginosis (BV) because it can be diagnosed in both members of the partnership. We conducted a nationwide community-enrolled cohort study of women who have sex with women, including women coenrolled with their regular female sexual partner (FSP), to investigate the BV incidence rate and factors associated with incident BV. METHODS: Women who have sex with women, without prevalent BV in a cross-sectional study, were enrolled in a 24-month cohort study involving 3-monthly questionnaires and self-collected vaginal swabs that were scored by the Nugent method. We assessed the BV incidence rate per 100 woman-years (WY) and used univariate and multivariable Cox regression analysis to establish factors associated with BV acquisition. RESULTS: Two hundred ninety-eight participants were enrolled in the cohort; 122 were coenrolled with their regular FSP. There were 51 incident cases of BV (rate, 9.75/100 WY; 95% confidence interval [CI], 7.41-12.83). Incident BV was associated with exposure to a new sexual partner (adjusted hazard ratio [AHR], 2.51; 95% CI, 1.30-4.82), a partner with BV symptoms (AHR, 3.99; 95% CI, 1.39-11.45), receptive oral sex (AHR, 3.52; 95% CI, 1.41-8.79), and onset of BV symptoms (AHR, 2.80; 95% CI, 1.39-5.61). Women coenrolled with their BV-negative partner had a greatly reduced risk of incident BV (AHR, 0.26; 95% CI, .11-.61), and high concordance of Nugent category (74%), which was predominantly normal vaginal flora throughout follow-up. CONCLUSIONS: These data highlight the strong influence of sexual relationships and behaviors on BV acquisition and the vaginal microbiota. They provide epidemiological evidence to support exchange of vaginal bacterial species between women and the concept that BV is sexually transmitted. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/25516188/Incident_bacterial_vaginosis__BV__in_women_who_have_sex_with_women_is_associated_with_behaviors_that_suggest_sexual_transmission_of_BV_ DB - PRIME DP - Unbound Medicine ER -