title: Association between semen exposure and incident bacterial vaginosis.
abstract: OBJECTIVE. To identify correlates of incident bacterial vaginosis (BV) diagnosed with Nugent scoring among high-risk women. STUDY DESIGN. We conducted both cohort and case-crossover analyses, stratified by HIV infection status, based on 871 HIV-infected and 439 HIV-uninfected participants in the HIV Epidemiology Research Study, conducted in 4 US sites in 1993-2000. RESULTS. BV incidence was 21% and 19% among HIV-infected and -uninfected women, respectively. Fewer correlates of BV were found with case-crossover than with cohort design. Reporting frequent coitus (regardless of consistency of condom use) was correlated with BV in cohort analyses but not in case-crossover analyses. The sole correlate of BV in both types of analyses was the detection of spermatozoa on Gram stain, which is a marker of semen exposure. CONCLUSION. The inconsistent association between condom use and BV in prior studies could be from reporting bias. We found evidence of a relationship between semen exposure and incident BV.
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. mgallo@cdc.gov
authors.forename: Maria F
authors.initials: MF
authors.lastname: Gallo
authors.forename: Lee
authors.initials: L
authors.lastname: Warner
authors.forename: Caroline C
authors.initials: CC
authors.lastname: King
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
authors.forename: Robert S
authors.initials: RS
authors.lastname: Klein
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: Anne M
authors.initials: AM
authors.lastname: Rompalo
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D018592:Cross-Over Studies; D005260:Female; D015658:HIV Infections / Q000150:complications; D018023:HIV Seronegativity; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D012661:Semen; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000209:etiology