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Sexual behaviors between women affected acquisition of bacterial vaginosis
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Sexual behaviors in female same-sex partnerships appear to have a strong influence on vaginal microbiota and the acquisition of bacterial vaginosis, researchers from the Melbourne Sexual Health Centre in Australia have found.
“Epidemiological studies in women who have sex with men consistently report a strong association between [bacterial vaginosis (BV)] and sexual activity,” the researchers wrote in Clinical Infectious Diseases. “Although there have been fewer epidemiological studies in women who have sex with women … BV has been associated with risk factors implicating sexual transmission between women. While these data support the concept of exchange of vaginal bacterial spp. between women, as in heterosexual couples, sexual transmission of BV has not been established.”
The researchers conducted a 24-month prospective cohort study between March 2010 and September 2013 to evaluate the incidence of and factors associated with incident BV. The study included 298 nonpregnant, pre-menopausal women with a female sex partner in the previous 18 months who were BV-negative on three weekly vaginal smears. Participants completed questionnaires and self-collected vaginal smears in 3-month intervals until incident BV or 24 months.
During 523 woman-years of follow-up, there were 51 cases of incident BV, for an incident rate of 9.75 per 100 woman-years. Women who were co-enrolled in the study with a female, BV-negative sex partner were significantly less likely to develop BV (adjusted HR=0.26; 95% CI, 0.11-0.61). In a multivariate analysis, factors associated with incident BV included a new sex partner within 90 days (aHR=2.51; 95% CI, 1.3-4.82); a female partner with BV symptoms (aHR=3.99; 95% CI, 1.39-11.45); receptive oral sex from any sex partner (aHR=3.52; 95% CI, 1.41-8.79); and abnormal vaginal discharge and/or odor (aHR=2.8; 95% CI, 1.39-5.61).
In further analysis, the researchers compared a reference group of women with a monogamous female sex partner and women who had not had sex, with: a) participants who had a sex partner with first sexual contact more than 90 days previously; and b) participants with a new sex partner within the previous 90 days. Women with a new sex partner within the previous 90 days had an eightfold greater risk for incident BV (aHR=7.59; 95% CI, 2.89-19.95), and women with a sex partner more than 90 days prior had a fourfold increased risk (aHR=3.82; 95% CI, 1.57-9.29).
“This study provides evidence for dynamic exchange of vaginal bacterial species between [female sex partners] and contributes to our understanding of how sexual behaviors and relationships influence the development of BV,” the researchers wrote. “Collectively, published epidemiological data provide broad support for male and female partner treatment trials to determine if this strategy reduces BV recurrence and associated sequelae.”
Disclosure: The researchers report no relevant financial disclosures.
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