title: Factors Associated with Bacterial Vaginosis among Women Who Have Sex with Women: A Systematic Review.
abstract: BACKGROUND
  Women who have sex with women (WSW) have a higher burden of bacterial vaginosis (BV) than heterosexual women; studies of risk factors specific to this population are limited. We summarised current knowledge regarding risk factors for BV among WSW by systematic review.
  
  
  METHODS
  This systematic review was conducted according to the PRISMA statement. PUBMED, EMBASE, Web of Science and The Cochrane Library were searched to 31st December, 2014.
  
  
  METHODS
  1) WSW included in the study population; 2) accepted BV diagnostic method; 3) investigated or could extrapolate factors(s) associated with BV acquisition, persistence or transmission in WSW specifically by comparing BV positive to BV negative women. Search was limited to English-language publications.
  
  
  RESULTS
  A limited number of studies have investigated BV in WSW. Of 71 unique references, 18 full-text articles were assessed and 14 studies fulfilled inclusion criteria. BV was positively associated with higher numbers of female partners, both lifetime and in the three months prior to diagnosis, and confirmed BV in a female partner, but inconsistently associated with partners' BV history or symptoms. BV was not associated with ethnicity, vaginal douching or hormonal contraception. The impact of specific sexual activities, male sexual contact, smoking and the menstrual cycle varied considerably between study populations.
  
  
  CONCLUSIONS
  BV in WSW is associated with increased numbers of recent and past female partners and confirmed BV in a female partner. There are limited studies of BV in WSW populations, and research is needed to further elucidate risk factors for BV among WSW. However these data provide epidemiological evidence that BV risk in women is directly related to exposure to other female partners and a partner with BV, providing support for the concept that BV is likely to be transmitted between women.
  CRD42014009536 (PROSPERO).
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia.|Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia.
authors.forename: Dana S
authors.initials: DS
authors.lastname: Forcey
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia.|Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia.
authors.forename: Lenka A
authors.initials: LA
authors.lastname: Vodstrcil
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia.|Central Clinical School, Monash University, The Alfred Centre, 55 Commercial Road, Melbourne, 3004, Victoria, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: The Kirby Institute, The University of New South Wales, 101 West Street, Darlinghurst, 2010, New South Wales, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Law
authors.affiliation: Department of General Practice, The University of Melbourne, Parkville, 3010, Victoria, Australia.
authors.forename: Ruth P
authors.initials: RP
authors.lastname: McNair
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, 3053, Victoria, Australia.|Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, The University of Melbourne, Parkville, 3010, Victoria, Australia.|Central Clinical School, Monash University, The Alfred Centre, 55 Commercial Road, Melbourne, 3004, Victoria, Australia.
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Bradshaw
mesh_terms: D005260:Female; D018452:Homosexuality, Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000382:microbiology