Risk factors for vulvovaginal candidiasis: a case-control study among university students

Vulvovaginal candidiasis (VVC) is a common inflammatory condition caused by vaginal overgrowth of Candida albicans. Typical symptoms include pruritus and discharge. To test the association between several hypothesized risk factors and VVC, we conducted a case-control study among university students, with both clinic and population controls. Symptomatic, culture-proven VVC was associated with receptive oral sex twice or more in the previous 2 weeks [vs not at all, odds ratio (OR) = 3.5; 95% confidence interval (CI) = 1.7-7.0]; oral contraceptive use (OR = 1.8; 95% CI = 0.95-3.6); spermicide use (OR = 3.3; 95% CI = 1.6-6.8); a prior diagnosis of VVC in the previous year (OR = 3.0; 95% CI = 1.5-5.9); and black (OR = 6.8; 95% CI = 3.1-15) and "other" race (OR = 2.2; 95% CI = 1.0-4.6). Estimates are from a cases vs population controls logistic regression model including all five variables; results for cases vs clinic controls were similar. After adjusting for these factors, many other hypothesized risk factors, such as antibiotic use, menstrual hygiene practices, and vaginal intercourse, had little association with VVC.