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Epidemiology oral session 5: Vaginal infections
O1-S05.03 Behavioural factors associated with Bacterial vaginosis (BV) in women who have sex with women (WSW): the Women On Women's (WOW) Health Study
  1. C Bradshaw1,
  2. J Bilardi2,
  3. S Walker2,
  4. L Vodstrcil2,
  5. S Garland3,
  6. J Hocking2,
  7. M Chen4,
  8. S Peterson4,
  9. G Fehler4,
  10. C Fairley2
  1. 1Melbourne Sexual Health Centre, University of Melbourne, Melbourne, Australia
  2. 2University of Melbourne, Melbourne, Australia
  3. 3Royal Womens Hospital, Australia
  4. 4Melbourne sexual health centre, Austria

Abstract

Background We are conducting a national 2 year cohort study in 400 Australian WSW to determine the behavioural and microbiological factors associated with prevalent and incident BV in women and their sexual partners. Data from the cross-sectional study will be presented.

Methods WSW were recruited using internet, festival and media-based promotion and were ineligible if they are postmenopausal, pregnant or had not had a female sex partner (FSP) in the last 18 months. Study-kits containing consent forms, questionnaires, swabs and slides were sent to participants and returned by post. At baseline, women self-collected three consecutive vaginal swabs and slides at weekly intervals and completed detailed demographic behavioural data via an online or paper-based questionnaire. Gram-stained self-collected vaginal smears (SCVS) were scored by the Nugent method. Women were classified as having prevalent BV if ≥1 slides had a Nugent score (NS) of 7–10, intermediate flora if ≥1 slides had a NS=4–6 and normal flora if all three slides had a NS=0–3. Univariate and multivariate analyses were performed using SPSS to examine the association between BV and behavioural practices.

Results In February 2011, 342 (86%) women had been recruited and 314 (92%) women had completed all cross-sectional requirements. Median age was 31 years (range 19–49), 309 (98%) reported a FSP in the last year, 253 (81%) had a current sexual partner (95% female) and 246 (78%) reported vaginal sex with a male in the past. The prevalence of BV was 29% (95% CI 20% to 38%) in women providing ≥1 SCVS. Two hundred and seventy-five (88%) women provided all three SCVS of which 178 (65%) had stable normal flora on all slides, 56 (20%) stable BV and 41 (15%) had unstable flora transitioning between ≥1 Nugent categories over the three slides. Multivariate analysis found that being a current smoker of cigarettes or marijuana (Adjusted OR AOR =2.2; 95% CI: 1.3% to 3.8%) and having >5 lifetime FSPs (AOR =1.8; 1.0 to 3.01) was significantly associated with prevalent BV. A borderline association with FSP receptive oral sex (AOR=3.2; 0.9 to 11.0) was evident. BV was not associated with increased age or numbers of male partners.

Conclusion Prevalent BV is common (30%) in WSW and is strongly associated with smoking and increasing numbers of FSPs but not male partners. A high proportion of WSW had stable vaginal flora (85%) over a 3 week period. This study aims to advance our understanding of epidemiology of BV in WSW.

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