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Published on: December 4, 2020
Vaginitis and Sexually Transmitted Infections Coinfections
Elizabeth M Marlowe1, Zhen Chen1, Ky Van1
1Quest Diagnostics, Secaucus, New Jersey; and Hologic, Inc, San Diego, California.
O&G Open
|July 25, 2026
Summary
Bacterial vaginosis (BV) significantly increases the risk of sexually transmitted infections (STIs) like Chlamydia trachomatis and Gonorrhea in women. Vulvovaginal candidiasis (VVC) does not show this association, highlighting the need for comprehensive STI screening in BV patients.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Clinical Diagnostics
Background:
- Bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) are common vaginal conditions in women.
- Concurrent sexually transmitted infections (STIs) can complicate diagnosis and treatment.
- Understanding the relationship between BV/VVC and STIs is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of STIs among women diagnosed with BV or VVC.
- To assess the association between BV/VVC and the risk of coinfection with specific STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium).
Main Methods:
- Retrospective cross-sectional study of over 1.5 million women aged 15+ undergoing molecular testing.
- Included testing for BV, VVC, C. trachomatis, N. gonorrhoeae, T. vaginalis, and M. genitalium.
- Used logistic regression to analyze the odds of STI positivity based on BV and VVC status.
Main Results:
- BV positivity was 38.7%, VVC positivity was 28.5%.
- Women with BV had significantly higher rates of at least one STI (12.0%) compared to those without BV (3.8%).
- BV+ status was independently associated with increased odds of C. trachomatis, N. gonorrhoeae, T. vaginalis, and M. genitalium infections.
Conclusions:
- Bacterial vaginosis is strongly linked to an increased risk of nonviral STI coinfection in women.
- Vulvovaginal candidiasis is not associated with an increased risk of these STIs.
- Comprehensive STI testing is recommended for women diagnosed with BV to improve clinical outcomes and prevent reproductive health complications.
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