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Infectious Diseases in Obstetrics and Gynecology
Volume 9 (2001), Issue 3, Pages 133-141
A Multicenter Study of Bacterial Vaginosis in Women With or at Risk for Human Immunodeficiency Virus Infection
1Centers for Disease Control and Prevention , Atlanta, GA, USA
2Division of Infectious Diseases, Department of Medicine and the Department of Epidemiology and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
3Division of Infectious Diseases, Wayne State University School of Medicine, Department of Medicine, Detroit, MI, USA
4Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
5Division of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, MD, USA
6Division of Infectious Diseases, Department of Medicine, Miriam and Memorial Hospitals and Brown University School of Medicine, Providence, RI, USA
71600 Clifton Road, Mailstop E-45, Division of HIV/AIDS Prevention, National Center for HIV, STD, TB Prevention, Centers for Disease Control and Prevention, Atlanta 30333, GA, USA
Received 23 April 2001; Accepted 28 May 2001
Copyright © 2001 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Bacterial vaginosis is a common gynecologic infection that has been associated with a variety of gynecologic and obstetric complications, including pelvic inflammatory disease, postabortal infection and premature delivery. Recent studies suggest that bacterial vaginosis may increase a woman’s risk for human immunodeficiency virus (HIV). We undertook this study to assess whether the prevalence and characteristics of bacterial vaginosis differed according to HIV status in high-risk US women.
Methods: Prevalence of bacterial vaginosis was assessed by Gram’s stain and clinical criteria for 854 HIV-infected and 434 HIV-uninfected women enrolled in the HIV Epidemiology Research (HER) Study.Multiple logistic regression techniques were used to determine whether HIV infection independently predicted bacterial vaginosis.
Results: Almost half (46%) the women had bacterial vaginosis by Gram’s stain. The prevalence of bacterial vaginosis was 47% in the HIV-positive women compared with 44% in the HIV-negativewomen; this difference was not statistically significant (p = 0.36). After adjustment for other covariates, HIV-positive women were more likely than HIV-negative women to have bacterial vaginosis (odds ratio (OR) 1.31; 95% confidence interval (CI) 1.01-1.70) by Gram's stain but not by clinical criteria (OR 1.16; CI 0.87-1.55). Among HIV-positive women, use of antiretroviral drugs was associated with a lower prevalence of bacterial vaginosis (adjusted OR 0.54; Cl 0.38 -0.77).
Conclusions: In this cross-sectional analysis of high-risk US women, HIV infection was positively correlated with bacterial vaginosis diagnosed by Gram’s stain.