Bacterial Vaginosis and Vaginal Yeast, But Not Vaginal Cleansing, Increase HIV-1 Acquisition in African Women

• DOI: 10.1097/qai.0b013e3181743936
• Publication Date: 2008-05-29T07:35:13Z
• Authors: Janneke H H M van...; Charles S Morrison; Peter G A Cornelisse; Marshall Munjoma; Jeanne Moncada; Peter Awio; Jing Wang; Barbara Van der Pol; Tsungai Chipato; Robert A Salata; Nancy S Padian
• Keywords: Gram staining; Vaginal discharge

Objective: To evaluate interrelationships between bacterial vaginosis (BV), vaginal yeast, practices (cleansing and drying/tightening), mucosal inflammation, HIV acquisition. Methods: A multicenter, prospective, observational cohort study was conducted, enrolling 4531 HIV-negative women aged 18 to 35 years attending family planning clinics in Zimbabwe Uganda. Participants were tested for reproductive tract infections interviewed about every 3 months 15 24 months. BV measured by Gram stain Nugent scoring, yeast wet mount, inflammation white blood cells on stain. Results: incidence 4.12 1.53 per 100 woman-years of follow-up Uganda, respectively (a total 213 incident infections). Women with or more likely acquire HIV, especially if the condition present at same visit as new infection preceding it (hazard ratio [HR] = 2.50, 95% confidence interval [CI]: 1.68 3.72 HR 2.97, CI: 1.67 5.28 respectively). These relationships did not seem be mediated inflammation. Vaginal drying/tightening associated acquisition univariate (HR 1.49, 1.03 2.15) but multivariate models. cleansing Conclusions: may contribute epidemic than previously thought.