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PROMISCUOUS SEXUAL ACTIVITY IS ASSOCIATED WITH BACTERIAL VAGINOSIS IN YOUNG WOMEN WHO DOUCHE

PROMISCUOUS SEXUAL ACTIVITY IS ASSOCIATED WITH BACTERIAL VAGINOSIS IN YOUNG WOMEN WHO DOUCHE. MK Oh , J Schwebke, J Merchant, P Brown, R Desmond, M Jones, H Weiss University of Alabama at Birmingham, Birmingham, AL. NIAID (U19AI3814- UAB CRC ). Background.

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PROMISCUOUS SEXUAL ACTIVITY IS ASSOCIATED WITH BACTERIAL VAGINOSIS IN YOUNG WOMEN WHO DOUCHE

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  1. PROMISCUOUS SEXUAL ACTIVITY IS ASSOCIATED WITH BACTERIAL VAGINOSIS IN YOUNG WOMEN WHO DOUCHE MK Oh, J Schwebke, J Merchant, P Brown, R Desmond, M Jones, H Weiss University of Alabama at Birmingham, Birmingham, AL. NIAID (U19AI3814- UAB CRC)

  2. Background • Vaginal douching has been linked to bacterial vaginosis (BV). • The mechanism of this association is unclear.

  3. Purpose: To determine correlates of BV in adolescent and young women who douche.

  4. Methods Study participants* • Women 14-21 years of age • Last douched within past 35 d. • Exclusion: pregnancy, chronic dz * B-WELL study: RCT of douching intervention

  5. Methods Baseline data included • Hx of douching • sexual behaviors • STD Hx • Lab tests (STDs, BV)

  6. Methods Douching history • Age at the 1st douching • Last douched (# of days ago) • Frequency • Timing • Reasons • Solutions used

  7. Methods • Sexual behaviors • Freq of sexual intercourse • Last sex (# of days ago) • # of partners (lifetime, in 3-mo.) • Condom use • BC use

  8. Methods Laboratory tests • BV (Nugent score ≥7) • C. trachomatis (CT) urine LCR • N. gonorrhoeae (GC) urine LCR • T. vaginalis by culture • HSV type specific serology by ELISA • HIV, VDRL

  9. Methods - Analyses Data from BV + at baseline (n=60) were compared with those who were BV negative (n= 84) • Student t-tests • Fisher’s Exact test • Logistic regression analysis

  10. Results - 144 participants • Mean age 18.7±1.9 yrs. • age at sexual debut 15.0±1.7 yrs. • 42% a history of STD • 26% a history of BV

  11. Sexual behaviors (n=144) • Last sex ≤7 days ago: 39% • >3 lifetime partners: 50% • >1 partner in past 3 mo: 21% • ≥10 times sex in 3 mo: 48% • Condom used /c last sex: 52% • Hormonal BC use, yes: 33%

  12. Lab tests (% positive)144 participants 42% 22% 14% 7% 5%

  13. Douching - 144 participants • Age at first douche: 15.8±1.9 yrs • Timing • after menses: 89% • after sex: 41% • before sex: 15% • before MD vst: 8% • Frequency • 44% - more than once a month • 32% - douched within the last wk.

  14. Variables associated /c BV

  15. Independent variables associated /c BV Adjusted O.R. 95% CI Multiple ptns >1 in 3-mo. Recent sex ≤ 7 days 1.02, 6.49 2.58 2.48 1.16, 5.30

  16. Among women who douche, BV was not significantly associated with • Frequency of douching • Recency of douching • Timing of douching • Types of solution used • Reasons for douching

  17. Limitations • Small sample size • All douched within the past 35 d. • Cross sectional - baseline data • Self-reported historical data

  18. Conclusion • BV positive rate was 42% in young women who douche. • Predictors of BV in these women were recent sex, multiple partners in recent 3-mo.

  19. B-WELL study is Supported by a grant from NIAID (U19AI3814- UAB CRC) - Edward W. Hook, III. • Acknowledgement to other coinvestigators on the study Sten Vermund Ellen Funkhouser Diane Grimley

  20. Implications • Studies examining effects of vaginal douching must account for confounding sexual behaviors. • Management of women with BV should include assessment for high risk sexual behavior and testing for STDs.

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