title: Risk factors for postcoital bleeding among women with or at risk for infection with human immunodeficiency virus.
abstract: Risk factors for postcoital bleeding were examined in 475 women who were enrolled in a study of heterosexual transmission of human immunodeficiency virus (HIV). In bivariate analyses, history of sexually transmitted diseases (STDs; P = .03), HIV infection (P = .008), and dyspareunia or pain during intercourse (P = .0001) were significant risk factors. In multivariate analysis, the two latter factors remained significant (for HIV, odds ratio [OR] = 2.1, P = .02, 95% confidence interval [CI] = 1.1-4.0; for dyspareunia, OR = 3.5, P < .001, 95% CI = 1.8-6.6), as did the interaction term of STD history and heavy smoking (OR = 2.4, P = .02, 95% CI = 1.2-5.0). Pain during intercourse was the strongest predictor of postcoital bleeding but may be part of the same phenomenon. Similarly, because this study relied on cross-sectional data, the direction of the causal pathway linking HIV to postcoital bleeding cannot be established. However, these data suggest that smoking, a modifiable risk factor, may increase risk of postcoital bleeding and contribute to susceptibility for HIV and other STDs.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco 94110, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Padian
authors.forename: J
authors.initials: J
authors.lastname: Abrams
authors.forename: J H
authors.initials: JH
authors.lastname: Skurnick
authors.forename: N L
authors.initials: NL
authors.lastname: Van Devanter
authors.forename: T R
authors.initials: TR
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003075:Coitus; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006470:Hemorrhage; D006801:Humans; D012307:Risk Factors; D014621:Vagina / Q000473:pathology*