Bacterial Vaginosis, Gonorrhea, and Chlamydial Infection Among Women Attending a Sexually Transmitted Disease Clinic: A Longitudinal Analysis of Possible Causal Links

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• 作者：Maria F. Gallo ; PhD^a ; ^{mgallo@cdc.gov} ; Maurizio Macaluso ; MD ; DrPH^a ; Lee Warner ; PhD^a ; Michael E. Fleenor ; MD ; MPH^b ; Edward W. Hook III ; MD^b ; ^c ; ^d ; ^e ; Ilene Brill ; MPH^c ; Mark A. Weaver ; PhD^f
• 关键词：Bacterial Vaginosis ; Epidemiology ; Incidence ; Sexually Transmitted Diseases ; Women
• 刊名：Annals of Epidemiology
• 出版年：2012
• 期刊代码：15_10472797
• 类别：med
• 出版时间：March, 2012
• 卷：22
• 期：3
• 页码：213-220
• 文件大小：245 K

摘要

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Purpose

Interactions between bacterial vaginosis (BV) and inflammatory sexually transmitted infections, such as gonorrhea and chlamydial infection, are not well understood. Furthermore, evidence regarding the sexual transmission of BV is equivocal.

Methods

We assessed associations between incident BV and incidences of gonorrhea and/or chlamydial infection (鈥済onorrhea/chlamydia鈥?, as well as similarities in associations for the two processes, among 645 female patients at a sexually transmitted disease clinic in Alabama followed prospectively for 6 months from 1995 to 1998. We identified predictors of both incident BV and gonorrhea/chlamydia and used bivariate logistic regression to determine whether these predictors differed.

Results

Participants completed 3188 monthly, follow-up visits. Several factors associated with incident BV involved sexual intercourse: young age (<16 years) at first intercourse (adjusted odds ratio [aOR], 1.5; 95%confidence interval [CI], 1.1-1.9), recent drug use during sex (aOR, 1.7; 95%CI, 1.2-2.5), prevalent trichomoniasis (aOR, 2.8; 95%CI, 1.7-4.6) and incident syphilis (aOR, 9.7; 95%聽CI, 1.9-48.4). Few statistical differences between potential factors for BV and gonorrhea/chlamydia emerged. BV appeared to precede the acquisition of gonorrhea/chlamydia (pairwise odds ratio, 1.6; 95%聽CI, 1.1-2.3), and vice versa (pairwise odds ratio, 2.4; 95%CI, 1.7-3.5).

Conclusions

Findings are consistent with a causal role of sexual behavior in the acquisition of BV and confirm that BV facilitates acquisition of gonorrhea/chlamydia and vice versa independently from other risk factors.