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Association between semen exposure and incident bacterial vaginosis
Maria F Gallo1, Lee Warner, Caroline C King
1Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. mgallo@cdc.gov
Infectious Diseases in Obstetrics and Gynecology
|December 23, 2011
Summary
Semen exposure, not condom use, is linked to bacterial vaginosis (BV) in high-risk women. This finding suggests reporting bias may explain inconsistent results in prior studies on BV and sexual practices.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Epidemiology
Background:
- Bacterial vaginosis (BV) is a common vaginal condition with unknown etiology.
- Previous studies have shown inconsistent associations between sexual practices and BV.
- High-risk women, including those with HIV, are particularly susceptible to BV.
Purpose of the Study:
- To identify correlates of incident bacterial vaginosis (BV) in high-risk women.
- To compare findings from cohort and case-crossover designs in BV research.
- To investigate the role of semen exposure and condom use in BV development.
Main Methods:
- Cohort and case-crossover analyses were conducted.
- Participants included 871 HIV-infected and 439 HIV-uninfected women.
- Bacterial vaginosis was diagnosed using Nugent scoring; semen exposure was detected via Gram stain.
Main Results:
- BV incidence was 21% in HIV-infected and 19% in HIV-uninfected women.
- Frequent coitus was correlated with BV in cohort but not case-crossover analyses.
- Spermatozoa detection (semen exposure) was the sole consistent correlate of incident BV.
Conclusions:
- Semen exposure, not condom use, is significantly associated with incident BV.
- Reporting bias may explain inconsistent findings regarding condom use and BV in previous studies.
- Understanding semen exposure's role is crucial for preventing BV in high-risk populations.
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