Vulvovaginal Candidiasis Among American Indian and Alaska Native People, Indian Health Service, 2016-2022

Vulvovaginal candidiasis (VVC) is an infection caused by the yeast Candida that affects more than 50% of women in their lifetime. We aimed to describe VVC among American Indian/Alaska Native (AI/AN) girls and women who were receiving care in the Indian Health Service (IHS) system during 2016-2022. We calculated the annual VVC prevalence per 1000 IHS user population and examined underlying medical conditions, previous diagnoses, and antifungal treatment. Among 6 million female patient-years, 70 766 patients had ≥1 VVC diagnosis code (2022 prevalence: 14.2 per 1000 IHS user population). Frequent previous or concurrent diagnoses included diabetes (24.8%), urinary tract infection (13.6%), screening for sexually transmitted infection (13.2%), and unspecified acute vaginitis or vulvitis (13.0%). Approximately one-third (33.1%) of patients received fluconazole, and 25.7% received prescription topical antifungal medication. VVC was a common condition among AI/AN patients who accessed care in the IHS health care system. VVC prevalence among AI/AN patients was similar to the prevalence among the broader US population. These data provide a baseline for future studies to evaluate diagnostic and treatment practices for VVC among AI/AN people.