Background Bacterial vaginosis (BV) is a common infection and has been associated with adverse health outcomes including preterm birth, pelvic inflammatory disease and acquisition of HIV and other sexually transmitted diseases. There are limited data on persistent BV in Indian women. This study examined the risk factors for persistent bacterial vaginosis in young reproductive women in India.

Study Design Between November 2005 and January 2007, a prospective cohort study was carried out to examine the relationship of BV and HSV-2 acquisition among women in Mysore. Quarterly, data were collected on sociodemographics, risk behaviour, partner characteristics, followed by a physical examination to diagnose and treat reproductive tract infections. BV was defined using Nugent scoring of gram stained vaginal smears. Persistent BV was calculated using generalised estimating equation methods. Women gave informed consent prior to enrolment in the study.

Results Of the 420 women for which there were data available for all three visits, 114 (27%) had two or more BV episodes. Women with a history of 2 or more BV episodes were more likely to be infected with Trichomonas vaginalis [OR 72.93, 95% CI 9.69 to 548.4] and be diagnosed with HSV-2 infection [OR 2.58, 95% CI 1.44 to 4.63] compared to women with no BV history. Women with a history of BV were also more likely to report no education, tubal ligation, being a non-Muslim, and having a sex partner who had other sex partners.

Conclusions Young reproductive age women in India have a high persistence of BV. Although the association between BV and Trichomonas vaginalis is unclear, it seems prudent to recommend that women with BV or TV be screened for both infections.