Factors associated with bacterial vaginosis (BV) at all visits in a repeated-measures analysis of 1027 women at high risk in Kampala, Uganda (2008–2011)
| Visits with BV diagnosed/ number of visits (%) | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | |
|---|---|---|---|
| Total | 3180/5569 (57.1%) | ||
| Socio-demographic factors (level 1)* | |||
| Age (years; n=5569) | ptrend=0.008 | ptrend=0.004 | |
| 14–24 | 1249/2111 (59.2%) | 1 | 1 |
| 25–34 | 1623/2836 (57.3%) | 0.89 (0.70 to 1.13) | 0.87 (0.69 to 1.11) |
| 35+ | 309/622 (49.7%) | 0.56 (0.38 to 0.82) | 0.54 (0.37 to 0.79) |
| Highest education (n=5569) | ptrend=0.03 | ptrend=0.01 | |
| Higher than primary level | 305/585 (52.1%) | 1 | 1 |
| Primary school completed | 1246/2223 (56.1%) | 1.19 (0.80 to 1.75) | 1.21 (0.82 to 1.80) |
| Primary school not completed | 1352/2321 (58.3%) | 1.31 (0.89 to 1.94) | 1.37 (0.93 to 2.03) |
| Never attended school | 278/440 (63.2%) | 1.81 (1.06 to 3.10) | 1.91 (1.12 to 3.26) |
| Regular partner (n=5566)† | p=0.29 | p=0.32 | |
| No | 702/1273 (55.2%) | 1 | 1 |
| Yes | 2478/4293 (57.7%) | 1.10 (0.92 to 1.33) | 1.09 (0.91 to 1.32) |
| Number of live births (n=5224)† | ptrend=0.06 | ptrend=0.52 | |
| None | 140/202 (69.3%) | 1 | 1 |
| 1–2 | 1570/2736 (57.4%) | 0.62 (0.34 to 1.16) | 0.66 (0.36 to 1.24) |
| 3–4 | 959/1715 (55.9%) | 0.56 (0.30 to 1.06) | 0.67 (0.35 to 1.28) |
| ≥5 | 309/571 (54.1%) | 0.49 (0.24 to 0.99) | 0.63 (0.30 to 1.33) |
| Sexual and behavioural factors (level 2)‡ | |||
| Age of first sex (years; n=5357)† | p=0.15 | p=0.76 | |
| ≤14 | 1128/1881 (60.0%) | 1 | 1 |
| 15–16 | 1182/2067 (57.2%) | 0.87 (0.66 to 1.13) | 0.93 (0.72 to 1.22) |
| 17–18 | 603/1140 (52.9%) | 0.69 (0.50 to 0.94) | 0.85 (0.62 to 1.18) |
| ≥19 | 152/269 (56.5%) | 0.87 (0.51 to 1.51) | 1.04 (0.60 to 1.79) |
| Number of lifetime sexual partners (n=5569) | ptrend<0.001 | ptrend<0.001 | |
| <20 | 347/690 (50.3%) | 1 | 1 |
| 20–50 | 428/841 (50.9%) | 1.05 (0.69 to 1.61) | 1.05 (0.69 to 1.60) |
| 50+ | 184/327 (56.3%) | 1.37 (0.79 to 2.39) | 1.39 (0.80 to 2.54) |
| Can't remember | 2222/3711 (59.9%) | 1.73 (1.22 to 2.44) | 1.79 (1.26 to 2.37) |
| Involvement in sex work (N=5564)† | p=0.14 | p=0.47 | |
| Only reports sex work for employment | 1040/1719 (60.5%) | 1 | 1 |
| Reports sex work and other employment | 1789/3183 (56.2%) | 0.86 (0.71 to 1.05) | 0.90 (0.75 to 1.09) |
| Reports no sex work | 348/662 (56.2%) | 0.78 (0.60 to 1.02) | 1.01 (0.72 to 1.43) |
| Number of paying sex partners in the past month (N=5569) | p=0.09 | p=0.79 | |
| 0–4 | 1005/1869 (53.8%) | 1 | 1 |
| 5–49 | 1648/2806 (58.7%) | 1.30 (1.01 to 1.67) | 1.09 (0.83 to 1.43) |
| 50+ or can't remember | 528/894 (59.1%) | 1.31 (0.93 to 1.84) | 1.01 (0.70 to 1.46) |
| Use of condoms with paying partners in the last month (N=5562)† | p=0.002 | ptrend<0.001 | |
| Never | 221/350 (63.1%) | 1 | 1 |
| Sometimes | 259/404 (64.1%) | 0.99 (0.68 to 1.43) | 0.99 (0.68 to 1.44) |
| Most of the time | 764/1223 (62.5%) | 0.90 (0.65 to 1.24) | 0.86 (0.63 to 1.19) |
| Always | 1374/2511 (54.7%) | 0.70 (0.51 to 0.94) | 0.68 (0.50 to 0.92) |
| Not applicable§ | 560/1074 (52.1%) | 0.65 (0.48 to 0.90) | 0.68 (0.49 to 0.93) |
| Alcohol use in the last three months (N=5567)† | p=0.002 | p=0.004 | |
| No | 882/1705 (51.7%) | 1 | 1 |
| Yes | 2298/3862 (59.5%) | 1.33 (1.11 to 1.59) | 1.30 (1.09 to 1.56) |
| Illicit drug use in the last three months (N=5569) | p=0.07 | p=0.35 | |
| No | 2406/4277 (56.3%) | 1 | 1 |
| Yes | 775/1292 (60.0%) | 1.20 (0.99 to 1.45) | 1.10 (0.81 to 1.33) |
| Intravaginal cleansing in the last three months (N=5558)† | p=0.29 | p=0.28 | |
| No | 183/334 (54.8%) | 1 | 1 |
| Yes, with water only | 1312/2346 (55.9%) | 0.96 (0.68 to 1.36) | 0.92 (0.65 to 1.30) |
| Yes, with soap | 1679/2878 (58.3%) | 1.09 (1.03 to 2.02) | 1.05 (0.75 to 2.58) |
| High-frequency cleansing in the last three months (N=5217)†,¶ | p=0.60 | p=0.37 | |
| No | 2096/3636 (57.7%) | 1 | 1 |
| Yes | 892/1581 (56.4%) | 0.96 (0.81 to 1.13) | 0.93 (0.78 to 1.10) |
| Insertion of a substance in the last three months (N=5568)†,** | p=0.11 | p=0.02 | |
| No | 2129/3660 (58.2%) | 1 | 1 |
| Yes | 1052/1908 (55.1%) | 0.88 (0.75 to 1.03) | 0.82 (0.69 to 0.97) |
| Biological factors (level 3)†† | |||
| Hormonal factors (contraception/pregnancy; N=5368)† | p=0.01 | p=0.02 | |
| No contraception | 1419/2338 (60.7%) | 1 | 1 |
| Oral contraceptive pill | 321/365 (56.8%) | 0.83 (0.56 to 1.23) | 0.81 (0.56 to 1.17) |
| Depot progesterone injection | 675/1309 (51.8%) | 0.63 (0.47 to 0.85) | 0.66 (0.50 to 0.86) |
| Other‡‡ | 557/955 (58.3%) | 0.94 (0.68 to 1.30) | 1.02 (0.75 to 1.38) |
| Pregnant | 209/401 (52.1%) | 0.61 (0.39 to 0.95) | 0.73 (0.48 to 1.10) |
| Vaginal yeast (N=5567)† | p<0.001 | p<0.001 | |
| No | 3012/5158 (58.4%) | 1 | 1 |
| Yes | 168/409 (41.1%) | 0.44 (0.34 to 0.58) | 0.45 (0.34 to 0.59) |
| Trichomonas vaginalis (N=5565)† | p=0.003 | p=0.05 | |
| No | 2728/4924 (55.4%) | 1 | 1 |
| Yes | 450/641 (70.2%) | 1.44 (1.14 to 1.84) | 1.27 (1.00 to 1.70) |
| Neisseria gonorrhoeae (N=5502)† | p=0.001 | p=0.05 | |
| No | 2799/5012 (55.9%) | 1 | 1 |
| Yes | 350/490 (71.4%) | 1.54 (1.19 to 1.99) | 1.30 (1.00 to 1.70) |
| Chlamydia trachomatis (N=5543)† | p=0.66 | p=0.86 | |
| No | 3010/5283 (57.0%) | 1 | 1 |
| Yes | 160/260 (61.5%) | 1.08 (0.77 to 1.52) | 1.03 (0.73 to 1.46) |
| Syphilis (N=5527)† | p<0.001 | p=0.001 | |
| Negative | 2404/4395 (54.7%) | 1 | 1 |
| Past syphilis (TPHA+/rpr−) | 332/540 (61.5%) | 1.40 (1.00 to 1.97) | 1.17 (0.84 to 1.63) |
| Positive:low titre (TPHA+/rpr<8) | 311/450 (69.1%) | 2.02 (1.43 to 2.85) | 1.47 (1.04 to 2.09) |
| Positive:high titre (TPHA+/rpr≥8) | 111/142 (78.2%) | 3.02 (1.71 to 5.34) | 2.95 (1.62 to 5.39) |
| Current herpes simplex virus (HSV)-2 status (N=5555)† | p<0.001 | p=0.001 | |
| Negative | 410/923 (44.4%) | 1 | 1 |
| Prevalent HSV | 2743/4593 (59.7%) | 2.23 (1.68 to 2.95) | 1.69 (1.27 to 2.24) |
| Incident HSV§§ | 23/39 (59.0%) | 2.41 (1.07 to 5.40) | 2.07 (0.88 to 4.84) |
| Current HIV status (N=5372)† | p<0.001 | p<0.001 | |
| Negative | 1704/3355 (50.8%) | 1 | 1 |
| Prevalent HIV | 1317/1986 (66.3%) | 2.35 (1.89 to 2.95) | 1.94 (1.54 to 2.44) |
| Incident HIV§§ | 23/31 (74.2%) | 3.88 (1.44 to 10.46) | 2.69 (0.98 to 7.37) |
*Adjusted for age and level of education.
†The difference from the number of visits (N=5569) is due to missing data.
‡BV at all visits adjusted for age, level of education, number of lifetime partners, frequency of condom use with clients, any use of alcohol and intravaginal insertion (n=1027, observations=5561).
§Includes those who did not have a paying partner in the past month.
¶High-frequency cleansing defined as cleansing >3 times/day, restricted to visits with reported cleansing in the past three months.
**Insertion of any of herbs, washing powder, soda, gel/lotions/Vaseline, saliva, other substances into vagina.
††BV adjusted for age, level of education, number of lifetime partners, frequency of condom use with clients, any use of alcohol, intravaginal insertion, HIV, HSV-2, vaginal yeast, T. vaginalis, N. gonorrhoeae, syphilis, hormonal contraception/pregnancy (N=1006, observations=4937).
‡‡Includes condoms, withdrawal methods, natural methods, traditional methods.
§§First diagnosed at this visit.
TPHA, Treponema pallidum haemagglutination test.