Viral sexually transmitted infections and bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey data.
BACKGROUND
Bacterial vaginosis (BV) is a common condition believed to be associated with sexually transmitted infection (STI) susceptibility. Most studies of BV and STIs have come from treatment-seeking or high-risk populations. This study examines the association between 5 viral STIs, human papilloma virus (HPV), HIV, herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2), and Hepatitis C (HCV), and BV among women in the general US population.


METHODS
Data from the 2001 and 2003-2004 National Health and Nutrition Examination Surveys were combined. Crude and adjusted relative risks and 95% confidence intervals were estimated from logistic regression analyses for rare outcomes (<10%) and from Poisson regression with robust error variance for common outcomes. Complex survey design was taken into consideration using the survey functions in Stata.


RESULTS
Crude analyses found an association between BV and the prevalence of all 5 STIs. After adjustment for important confounders, only HSV-1 and HSV-2 were significantly associated with the presence of BV. Moreover, crude analyses stratified by race/ethnicity suggested that associations between BV and viral STIs may not be consistent across race/ethnicity subgroups.


CONCLUSIONS
This population-based study found that BV was significantly associated with the prevalence of HSV-1 and HSV-2 and potentially associated with HIV and HPV. Given the frequency of BV in US women, small increases in STI susceptibility may have important impacts on STI transmission.
Allsworth
Jenifer E
JE
Department of Obstetrics and Gynecology, Washington University in St. Louis, School of Medicine, St. Louis, Missouri 63110, USA. allsworthj@wudosis.wustl.edu
Lewis
Vanessa A
VA
Peipert
Jeffrey F
JF
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology; D006558:Herpes Genitalis / Q000453:epidemiology / Q000209:etiology; D006561:Herpes Simplex / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology* / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000208:ethnology