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Bacterial vaginosis among women at high risk for HIV in Uganda: high rate of
recurrent diagnosis despite treatment
#MMPMID26253744
Francis SC
; Looker C
; Vandepitte J
; Bukenya J
; Mayanja Y
; Nakubulwa S
; Hughes P
; Hayes RJ
; Weiss HA
; Grosskurth H
Sex Transm Infect
2016[Mar]; 92
(2
): 142-8
PMID26253744
show ga
OBJECTIVES: Bacterial vaginosis (BV) is associated with increased risk for
sexually transmitted infections (STIs) and HIV acquisition. This study describes
the epidemiology of BV in a cohort of women at high risk for STI/HIV in Uganda
over 2?years of follow-up between 2008-2011. METHODS: 1027 sex workers or bar
workers were enrolled and asked to attend 3-monthly follow-up visits. Factors
associated with prevalent BV were analysed using multivariate random-effects
logistic regression. The effect of treatment on subsequent episodes of BV was
evaluated with survival analysis. RESULTS: Prevalences of BV and HIV at enrolment
were 56% (573/1027) and 37% (382/1027), respectively. Overall, 905 (88%) women
tested positive for BV at least once in the study, over a median of four visits.
Younger age, a higher number of previous sexual partners and current alcohol use
were independently associated with prevalent BV. BV was associated with STIs,
including HIV. Hormonal contraception and condom use were protective against BV.
Among 853 treated BV cases, 72% tested positive again within 3?months. There was
no difference in time to subsequent BV diagnosis between treated and untreated
women. CONCLUSIONS: BV was highly prevalent and persistent in this cohort despite
treatment. More effective treatment strategies are urgently needed.
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