title: Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.
abstract: BACKGROUND
  Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women's recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV.
  
  
  METHODS
  A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews.
  
  
  RESULTS
  The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women's frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching.
  
  
  CONCLUSIONS
  In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.
authors.affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia.|Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Jade
authors.initials: J
authors.lastname: Bilardi
authors.affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Walker
authors.affiliation: Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: McNair
authors.affiliation: Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Mooney-Somers
authors.affiliation: Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Temple-Smith
authors.affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Bellhouse
authors.affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Fairley
authors.affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Marcus
authors.initials: M
authors.lastname: Chen
authors.affiliation: Central Clinical School, Monash University, Melbourne, Victoria, Australia.|Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia.|Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Catriona
authors.initials: C
authors.lastname: Bradshaw
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D006801:Humans; D008019:Life Style; D036301:Qualitative Research; D012008:Recurrence; D012307:Risk Factors; D012651:Self Medication; D012725:Sexual Behavior; D016585:Vaginosis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents