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Medline ® Abstracts for References 29-31

of 'Bacterial vaginosis'

29
TI
Bacterial vaginosis and susceptibility to HIV infection in South African women: a nested case-control study.
AU
Myer L, Denny L, Telerant R, Souza M, Wright TC Jr, Kuhn L
SO
J Infect Dis. 2005;192(8):1372.
 
BACKGROUND: Bacterial vaginosis (BV) may increase women's susceptibility to HIV infection, but there are few prospective data.
METHODS: During follow-up for up to 36 months, 86 new HIV seroconverters (case patients) were identified among 5110 women enrolled in a cervical cancer screening trial. Nonseroconverting control subjects (n=324) were frequency matched to case patients by age and duration of follow-up. At enrollment, case patients and control subjects were evaluated for clinical signs of BV, and Gram stains of vaginal fluid were scored using Nugent criteria.
RESULTS: BV was diagnosed on the basis of clinical criteria at enrollment in 20% of seroconverters and 16% of control subjects (summary odds ratio [OR], 1.31 [95% confidence interval {CI}, 0.71-2.41]). Nugent criteria for BV were met by 74% of seroconverters and 62% of control subjects. Diagnosis of BV on the basis of Nugent criteria was significantly associated with an increased risk of HIV seroconversion, after adjustment for demographic characteristics, other sexually transmitted infections, and sexual behaviors (adjusted OR, 2.01 [95% CI, 1.12-3.62]).
CONCLUSIONS: BV may account for a substantial fraction of new HIV infections in this setting. Treatment of BV and other interventions to promote normal vaginal flora warrant attention for HIV prevention.
AD
Infectious Diseases Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
PMID
30
TI
Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina.
AU
Ness RB, Hillier SL, Richter HE, Soper DE, Stamm C, McGregor J, Bass DC, Sweet RL, Rice P
SO
Obstet Gynecol. 2002;100(4):765.
 
OBJECTIVE: To study how frequency, recentness, and reason for douching impact bacterial vaginosis-related vaginal microflora and the occurrence of cervical pathogens. Douching has been linked to bacterial vaginosis as well as to chlamydial cervicitis in some, but not all, studies.
METHODS: A total of 1200 women at high risk for sexually transmitted infections were enrolled from five clinical sites around the United States. Cross-sectional, structured interviews were conducted and vaginal swabs were self-obtained for Gram stain, culture, and DNA amplification tests for Neisseria gonorrhoeae and Chlamydia trachomatis.
RESULTS: Douching at least once per month was associated with an increased frequency of bacterial vaginosis. Those who douched recently (within 7 days) were at highest risk [odds ratio (OR) 2.1, 95% confidence interval (CI) 1.3, 3.1]. Douching for symptoms (OR 1.7, 95% CI 1.1, 2.6) and for hygiene (OR 1.3, 95% CI 1.0, 1.9) both related to bacterial vaginosis risk. The associations between douching and Gardnerella vaginalis, Mycoplasma hominis, and lack of hydrogen peroxide-producing lactobacilli were similar to those between douching and bacterial vaginosis. Gonococcal or chlamydial cervicitis was not associated with douching.
CONCLUSION: Douching for symptoms or hygiene, particularly frequent or recent douching, was associated with bacterial vaginosis and bacterial vaginosis-associated vaginal microflora, but not with gonococcal or chlamydial cervicitis.
AD
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. repro@pitt.edu
PMID
31
TI
Predictors of bacterial vaginosis in adolescent women who douche.
AU
Schwebke JR, Desmond RA, Oh MK
SO
Sex Transm Dis. 2004;31(7):433.
 
OBJECTIVE: Risk factors for bacterial vaginosis (BV) include douching and sexual activity, although the exact cause of BV is unknown.
GOAL: The goal of this study was to determine the relative significance of douching as a risk factor for BV.
STUDY DESIGN: Two hundred fifty adolescent women who regularly douched were enrolled into a randomized douching intervention trial. Behavioral questionnaires and testing for sexually transmitted diseases and BV were performed. Associations between baseline characteristics and behaviors were compared for teens who were BV-positive and BV-negative at baseline.
RESULTS: Positive correlates of BV included multiple partners, recent sexual intercourse, douching after menses, recent douching, and gonorrhea. Of these, douching after menses showed the strongest association (odds ratio, 5.11; 95% confidence interval, 1.99-13.15) in a multivariate analysis.
CONCLUSIONS: Douching after menses was strongly correlated with BV; however, difficulty remains in trying to evaluate douching and sexual behavior independently.
AD
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA. schwebke@uab.edu
PMID