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. 2013;8(3):e57688.
doi: 10.1371/journal.pone.0057688. Epub 2013 Mar 5.

Prevalent and incident bacterial vaginosis are associated with sexual and contraceptive behaviours in young Australian women

Catriona S Bradshaw  1 , Jennifer Walker, Christopher K Fairley, Marcus Y Chen, Sepehr N Tabrizi, Basil Donovan, John M Kaldor, Kathryn McNamee, Eve Urban, Sandra Walker, Marian Currie, Hudson Birden, Francis Bowden, Suzanne Garland, Marie Pirotta, Lyle Gurrin, Jane S Hocking
Affiliations

Prevalent and incident bacterial vaginosis are associated with sexual and contraceptive behaviours in young Australian women

Catriona S Bradshaw et al. PLoS One. 2013.

Abstract

Background: To determine prevalence and incidence of bacterial vaginosis (BV) and risk factors in young sexually-active Australian women.

Methods: 1093 women aged 16-25 years were recruited from primary-care clinics. Participants completed 3-monthly questionnaires and self-collected vaginal smears 6-monthly for 12-months. The primary endpoint was a Nugent Score = 7-10 (BV) and the secondary endpoint was a NS = 4-10 (abnormal flora [AF]). BV and AF prevalence estimates and 95% confidence intervals (95%CI) were derived, and adjusted odds ratios (AOR) calculated to explore epidemiological associations with prevalent BV and AF. Proportional-hazards regression models were used to examine factors associated with incident BV and AF.

Results: At baseline 129 women had BV [11.8% (95%CI: 9.4-14.2)] and 188 AF (17.2%; 15.1-19.5). Prevalent BV was associated with having a recent female partner [AOR = 2.1; 1.0-4.4] and lack of tertiary-education [AOR = 1.9; 1.2-3.0]; use of an oestrogen-containing contraceptive (OCC) was associated with reduced risk [AOR = 0.6; 0.4-0.9]. Prevalent AF was associated with the same factors, and additionally with >5 male partners (MSP) in 12-months [AOR = 1.8; 1.2-2.5)], and detection of C.trachomatis or M.genitalium [AOR = 2.1; 1.0-4.5]. There were 82 cases of incident BV (9.4%;7.7-11.7/100 person-years) and 129 with incident AF (14.8%; 12.5-17.6/100 person-years). Incident BV and AF were associated with a new MSP [adjusted rate ratio (ARR) = 1.5; 1.1-2.2 and ARR = 1.5; 1.1-2.0], respectively. OCC-use was associated with reduced risk of incident AF [ARR = 0.7; 0.5-1.0].

Conclusion: This paper presents BV and AF prevalence and incidence estimates from a large prospective cohort of young Australian women predominantly recruited from primary-care clinics. These data support the concept that sexual activity is strongly associated with the development of BV and AF and that use of an OCC is associated with reduced risk.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Cases of bacterial vaginosis, Chlamydia trachomatis and Mycoplasma genitalium at recruitment and co-infections.
See this image and copyright information in PMC

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