title: Correlates of Bacterial Vaginosis Over Long-Term Follow-Up: Impact of HIV Infection.
abstract: Correlates of bacterial vaginosis (BV) are poorly understood, especially in HIV infection. In a cohort study, HIV-seropositive and comparison seronegative women were assessed every 6 months during 1994-2015. BV was considered present when three of four Amsel criteria were met. Behavioral characteristics were assessed using structured interviews. Multivariable logistic regression used generalized estimating equation models to determine factors associated with BV. Cumulative incidence of BV over time was assessed using the log-rank test. Among 3,730 women (964 HIV seronegative and 2,766 HIV seropositive) contributing 70,970 visits, BV was diagnosed at 2,586 (14.0%) visits by HIV-seronegative women and 6,224 (11.9%) visits by HIV-seropositive women (p < .0001). The cumulative incidence of BV was 530/964 (55.0%) in HIV-seronegative women and 1,287/2,766 (46.5%) in seropositive women (p < .0001). In adjusted analyses, factors associated with BV were younger age, ethnicity, lower income, less education, recruitment site, recruitment in the 2001-2002 cohort, heavier drinking, current smoking, depression, and sex with a male partner; both hormonal contraception and menopause were negatively associated with BV. Of 533 women with prevalent BV, 228 (42.8%) recurred within a year, while persistent BV was found in 12.8% of participants; neither proportion differed by HIV serostatus. Time trends in the proportion of women with BV at any single visit were not identified. BV is common among women with and at risk for HIV, but HIV infection does not predispose to BV, which is associated instead with behavioral and cultural factors.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Washington University School of Medicine , St. Louis, Missouri.
authors.forename: Leslie S
authors.initials: LS
authors.lastname: Massad
authors.affiliation: 2 Department of Preventive Medicine, Center for Healthcare Studies, Northwestern University , Chicago, Illinois.
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.affiliation: 3 Center for Healthcare Studies, Northwestern University , Chicago, Illinois.
authors.forename: Raymond
authors.initials: R
authors.lastname: Kang
authors.affiliation: 4 Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health , Chicago, Illinois.
authors.forename: Anna
authors.initials: A
authors.lastname: Hotton
authors.affiliation: 5 Department of Clinical Pharmacy, University of California , San Francisco, California.|6 Department of Medicine, University of California , San Francisco, California.|7 Department of Epidemiology and Biostatistics, University of California , San Francisco, California.
authors.forename: Ruth
authors.initials: R
authors.lastname: Greenblatt
authors.affiliation: 8 Department of Obstetrics and Gynecology, Maimonides Medical Center , Brooklyn, New York.
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.affiliation: 9 Department of Medicine, Albert Einstein School of Medicine/Montefiore Medical Center , Bronx, New York.
authors.forename: Kerry
authors.initials: K
authors.lastname: Murphy
authors.affiliation: 10 Department of Obstetrics and Gynecology, Georgetown University , Washington, District of Columbia.
authors.forename: Christine
authors.initials: C
authors.lastname: Colie
authors.affiliation: 11 The CORE Center at John H. Stroger Jr. Hospital of Cook County , Chicago, Illinois.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Weber
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016585:Vaginosis, Bacterial / Q000453:epidemiology*; D055815:Young Adult
keywords: Amsel criteria; HIV in women; bacterial vaginosis