title: Prevalence of bacterial vaginosis and Candida among postmenopausal women in the United States.
abstract: OBJECTIVE
  To describe the prevalence of bacterial vaginosis (BV) and Candida among community-dwelling postmenopausal women in the United States and determine their change with age, using estimates based on Waves 1 and 2 of the National Social Life, Health and Aging Project (NSHAP).
  
  
  METHODS
  Self-administered vaginal swabs were collected in-home from women aged 57-85 (n = 1,016) in Wave 1 and again 5 years later in Wave 2 (n = 883). Gram-stained specimens were evaluated for BV using the Nugent score as well as presence of Candida.
  
  
  RESULTS
  BV was prevalent in 23% and 38% of postmenopausal women in Waves 1 and 2 and increased with age. Women initially categorized with BV in Wave 1 were more than 10 times as likely to be categorized with BV in Wave 2, relative risk ratio (RRR) = 10.5; 95% confidence interval (CI) (4.45-24.7); p < .001, whereas women initially categorized as intermediate in Wave 1 were five times more likely to have a BV categorization, RRR = 5.0; 95% CI (2.56-9.75); p < .001. Although the presence of Candida was similar in both waves (6% and 5%), its relationship with age only became evident in Wave 2, with odds of detecting Candida decreasing by 7% with each year of age, OR = 0.93, 95% CI (0.88, 0.98); p = .010.
  
  
  CONCLUSIONS
  In Wave 2, the prevalence of BV was higher and increased with age while the prevalence of Candida was low and declined with age. A 5-year age increase contributed to the prevalence change across waves. Methods refinements in Wave 2 improved the detection of BV and Candida and clarified their relationship with age.
authors.affiliation: Institute for Mind and Biology, University of Chicago, Illinois. jnhoffma@uchicago.edu.
authors.forename: Joscelyn N
authors.initials: JN
authors.lastname: Hoffmann
authors.affiliation: Institute for Mind and Biology, University of Chicago, Illinois.
authors.forename: Hannah M
authors.initials: HM
authors.lastname: You
authors.affiliation: Academic Research Centers and Education and Child Development Studies, NORC at the University of Chicago, Illinois. Sanford School of Social and Family Dynamics, Arizona State University, Tempe.
authors.forename: E C
authors.initials: EC
authors.lastname: Hedberg
authors.affiliation: Department of Epidemiology and Biostatistics, George Washington University, Washington, DC.
authors.forename: Jeanne A
authors.initials: JA
authors.lastname: Jordan
authors.affiliation: Institute for Mind and Biology, University of Chicago, Illinois. Departments of Psychology and Comparative Human Development, University of Chicago, Illinois.
authors.forename: Martha K
authors.initials: MK
authors.lastname: McClintock
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D014481:United States / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000453:epidemiology*
keywords: Bacterial vaginosis; Candida; Population; Postmenopause; Self-collection; Vaginal swab.