A multicenter study of bacterial vaginosis in women with or at risk for human immunodeficiency virus infection.
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-negative women; 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.
Warren
D
D
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Klein
R S
RS
Sobel
J
J
Kieke
B
B
Brown
W
W
Schuman
P
P
Anderson
J
J
Cu-Uvin
S
S
Mayer
K
K
Jamieson
D J
DJ
Holmberg
S
S
Duerr
A
A
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005840:Gentian Violet; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010619:Phenazines; D015995:Prevalence; D012307:Risk Factors; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet