Higher-risk behavioral practices associated with bacterial vaginosis compared with vaginal candidiasis.
OBJECTIVE
Bacterial vaginosis has been associated with hormonal factors and sexual practices; however, the cause is unclear, and the notion that bacterial vaginosis is a sexually transmitted infection is still debated. To investigate whether bacterial vaginosis is associated with specific sexual practices or instead has features in common with a sexually transmitted infection, we compared behavioral associations in women with bacterial vaginosis to women with vaginal candidiasis.


METHODS
Women with symptoms of abnormal vaginal discharge or odor who attended Melbourne Sexual Health Centre between July 2003 and August 2004 were eligible for enrollment in the study. Information on demographics and behavioral and contraceptive practices were collected by self-completed questionnaire. Participants were tested for bacterial vaginosis, Candida spp (microscopy and culture), and sexually transmitted infections. Statistical comparisons were made between women with and without bacterial vaginosis and women with and without candidiasis, using univariate and multivariate analysis.


RESULTS
A total of 342 women were enrolled in the study; 157 were diagnosed with bacterial vaginosis, 51 had candidiasis by microscopy, and 95 had candidiasis by culture. Bacterial vaginosis was associated with indicators of high-risk sexual behavior such as a new sexual partner and greater number of male partners in the last year, increased number of lifetime sexual partners, less than 13 years of education, a past history of pregnancy, and smoking (P < .05). Candidiasis was not associated with these risk behaviors and was instead related to practices such as receptive anal and oral sex and douching.


CONCLUSIONS
The association between bacterial vaginosis and practices that are associated with sexually transmitted infections, in contrast to those observed with candidiasis, suggests a possible sexually transmitted cause.


METHODS
II-2.
Bradshaw
Catriona Susan
CS
Melbourne Sexual Health Centre, The Alfred Hospital, Victoria, Australia.
Morton
Anna N
AN
Garland
Suzanne M
SM
Morris
Margaret B
MB
Moss
Lorna M
LM
Fairley
Christopher K
CK
D000328:Adult; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D015331:Cohort Studies; D016001:Confidence Intervals; D018562:Disease Transmission, Infectious; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D018570:Risk Assessment; D012309:Risk-Taking; D012720:Severity of Illness Index; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*