TOPLINE

Women with laboratory-confirmed bacterial vaginosis (BV) showed higher risk for concurrent sexually transmitted infections (STIs) compared with those without BV, independent of vulvovaginal candidiasis (VVC) status.

METHODOLOGY

• Researchers conducted a retrospective study of more than 1.5 million females aged 15 years or older (mean age, 36 years) who underwent testing for BV, VVC, Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis at a US national reference laboratory from 2022 to 2024.
• A subset of more than 37,000 women also underwent molecular testing for Mycoplasma genitalium.
• Analysis included a single BV test per patient during the study period; testing for other STIs within 7 days of a BV result was considered a testing event.

TAKEAWAY

• Overall, 38.7% of participants tested positive for BV, 28.5% for VVC, and 10.8% tested positive for both conditions.
• Among participants who tested positive for BV, 10.9% had only one STI and 1.1% had 2-4 STIs; among those who tested negative, 3.6% had only one STI and 0.2% had 2-4 STIs (P < .001). Participants who tested positive for BV had an increased rate of STI infection than those who tested negative (12.0% vs 3.8%; P < .001).
• After adjustment for age, geographic region, and VVC results, BV-positive status was associated with increased odds of testing positive for C trachomatis (odds ratio [OR], 2.8; P < .001), N gonorrhoeae (OR, 3.8; P < .001), T vaginalis (OR, 3.6; P < .001), and M genitalium (OR, 1.9; P < .001).
• VVC alone was not significantly associated with increased STI risk, whereas BV remained an independent predictor of STI coinfection even after adjustment for VVC.

IN PRACTICE

"BV is strongly associated with increased risk of multiple nonviral STI coinfections among US women," the authors wrote. "These findings have important implications for clinical practice and public health and support routine comprehensive STI testing in the management of BV."

SOURCE

The study was led by Elizabeth M. Marlowe, MS, PhD, Quest Diagnostics, Secaucus, New Jersey. It was published online on July 23 in O&G Open.

LIMITATIONS

Limitations included retrospective design and reliance on reference laboratory data. The study could not distinguish incidence of new infections from prevalence of existing infections.

DISCLOSURES

This study was supported by Quest Diagnostics. Several authors are reported as being employees and stockholders of Quest Diagnostics and Hologic.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.