title: Bacterial vaginosis, ethnicity, and the use of genital cleaning agents: a case control study.
abstract: OBJECTIVE
  Bacterial vaginosis and vaginal douching are both reported to be more common in African-American and Caribbean than white women. It is also thought that douching alters the vaginal milieu. This study was conducted to examine associations between genital cleaning practices, bacterial vaginosis, and ethnic group.
  
  
  METHODS
  Case-control study of 100 women with bacterial vaginosis, diagnosed by Nugent's criteria, and 100 women without bacterial vaginosis attending a sexually transmitted diseases clinic in an ethnically heterogeneous inner-city area in London, England.
  
  
  RESULTS
  Bacterial vaginosis was more common among black Caribbean than white women (OR, 2.1; 95% CI, 1.1-4.1). Vulval use of bubble bath or antiseptic solutions and douching with proprietary or homemade solutions were significantly more common in women with bacterial vaginosis than without. After controlling for use of vulval and vaginal antiseptics and bubble bath, douching, and a history of bacterial vaginosis, there was no ethnic difference in the occurrence of the condition (adjusted OR, 1.1; 95% CI, 0.5-2.5).
  
  
  CONCLUSIONS
  Ethnic differences in genital hygiene behaviors can explain a twofold increase in the risk of bacterial vaginosis in black Caribbean compared with white women. The role of vulval and vaginal cleaning practices in the development of bacterial vaginosis should be examined further in longitudinal or randomized controlled studies.
authors.affiliation: The Caldecot Centre, King's NHS Healthcare Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rajamanoharan
authors.forename: N
authors.initials: N
authors.lastname: Low
authors.forename: S B
authors.initials: SB
authors.lastname: Jones
authors.forename: A L
authors.initials: AL
authors.lastname: Pozniak
mesh_terms: D000328:Adult; D001741:Black or African American; D000891:Anti-Infective Agents, Local; D016022:Case-Control Studies; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D006920:Hygiene; D012915:Soaps; D007507:Therapeutic Irrigation / Q000009:adverse effects*; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000208:ethnology* / Q000209:etiology* / Q000517:prevention & control; D014844:Vulva / Q000382:microbiology; D044465:White People
chemical_list: D000891:Anti-Infective Agents, Local; D012915:Soaps