Burden and determinants of Bacterial vaginosis in sexually active women aged 18 years and over, enrolled in an HIV prevention trial, in northern KwaZulu Natal

Abstract

Background: Bacterial vaginosis (BV) results from a shift in normal vaginal flora and predisposes women to sexually transmitted infections (STI) including HIV. Risk factors for BV are not well understood. This analysis seeks to determine the disease frequency of BV, assess determinants of BV and quantify time to first BV episode in HIV negative women. Methods: Baseline and follow-up data from 1066 women was analysed in STATA10. Logistic regression was used to determine baseline factors associated with BV and Kaplan Meier survival analysis to estimate time to BV episode. Results: BV prevalence and incidence was estimated at 48.42% and 81 cases per 100 women years respectively. Controlling for age and education, women with Trichomonas vaginalis, Chlamydia trachomatis, Herpes Simplex Virus2 and lower socio-economic status were 67%- 380%, 31%-472%, 20%-220% and 4%-91% more likely to present with BV respectively. Consistent condom use and being a housewife or student was significantly (p<0.05) associated with lower prevalent BV, with a significant interaction between age and education (p<0.05). The median time to first BV episode was 9.7 months. Conclusion: The analysis identifies modifiable risk factors like condom use, injectable contraceptives and treatment of STIs which could potentially decrease the high BV disease burden.