Article Text

Original article
Bacterial vaginosis among women at high risk for HIV in Uganda: high rate of recurrent diagnosis despite treatment
  1. Suzanna C Francis1,
  2. Clare Looker1,
  3. Judith Vandepitte2,
  4. Justine Bukenya2,
  5. Yunia Mayanja2,
  6. Susan Nakubulwa2,
  7. Peter Hughes2,
  8. Richard J Hayes1,
  9. Helen A Weiss1,
  10. Heiner Grosskurth1,2
  1. 1MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
  2. 2MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
  1. Correspondence to Dr Suzanna C Francis, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; suzanna.francis{at}


Objectives Bacterial vaginosis (BV) is associated with increased risk for sexually transmitted infections (STIs) and HIV acquisition. This study describes the epidemiology of BV in a cohort of women at high risk for STI/HIV in Uganda over 2 years of follow-up between 2008–2011.

Methods 1027 sex workers or bar workers were enrolled and asked to attend 3-monthly follow-up visits. Factors associated with prevalent BV were analysed using multivariate random-effects logistic regression. The effect of treatment on subsequent episodes of BV was evaluated with survival analysis.

Results Prevalences of BV and HIV at enrolment were 56% (573/1027) and 37% (382/1027), respectively. Overall, 905 (88%) women tested positive for BV at least once in the study, over a median of four visits. Younger age, a higher number of previous sexual partners and current alcohol use were independently associated with prevalent BV. BV was associated with STIs, including HIV. Hormonal contraception and condom use were protective against BV. Among 853 treated BV cases, 72% tested positive again within 3 months. There was no difference in time to subsequent BV diagnosis between treated and untreated women.

Conclusions BV was highly prevalent and persistent in this cohort despite treatment. More effective treatment strategies are urgently needed.


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.