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Cited by 714Reproductive tract infections researchHIV/AIDS Research and InterventionsCervical Cancer and HPV Research

Bacterial vaginosis and HIV acquisition: A meta-analysis of published studies

Open access
Atashili, Julius, Poole, Charles, Ndumbe, Peter M, Adimora, Adaora A, Smith, Jennifer S·2008·AIDS
DOI 10.1097/qad.0b013e3283021a37PMC PMC2788489
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Abstract

OBJECTIVES: To assess and summarize the published literature on the extent to which bacterial vaginosis may increase the risk of HIV acquisition. DESIGN: Meta-analysis of published studies. METHODS: Medline and other electronic databases were systematically searched for eligible publications. The association between bacterial vaginosis and incident HIV was separately analyzed from that between bacterial vaginosis and prevalent HIV. The latter was further analyzed, stratified by bacterial vaginosis diagnostic method, HIV risk profile of the study population, and whether or not adjusted estimates were presented. RESULTS: Twenty-three eligible publications were identified, including a total of 30,739 women. Bacterial vaginosis was associated with an increased risk of HIV acquisition in HIV-incidence studies (relative risk = 1.6, 95% confidence interval: 1.2, 2.1). All but one of 21 HIV-prevalence studies reported estimates above the null. The latter results were heterogeneous and showed some evidence of funnel plot asymmetry, precluding the estimation of a single summary measure. The association between bacterial vaginosis and HIV in prevalence studies appeared stronger for women without high-risk sexual behavior. CONCLUSION: Bacterial vaginosis was consistently associated with an increased risk of HIV infection. High bacterial vaginosis prevalence may result in a high number of HIV infections being attributable to bacterial vaginosis. More prospective studies are needed to accurately evaluate the role of bacterial vaginosis in HIV acquisition in low-risk versus high-risk women. Furthermore, randomized clinical trials may be worth considering to determine the effect of bacterial vaginosis control measures on HIV acquisition.

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  • Bacterial vaginosis is more prevalent in women from African, Caribbean, and Black communities and is consistently associated with a 2-5-fold increase in HIV-1 risk.

    “Moreover, the presence of BV, which is more prevalent in women from ACB communities [9–11], has been consistently associated with a 2-5-fold increase in HIV-1 risk [12, 13].”

    From Feasibility, safety and tolerability of estrogen and/or probiotics for improving vaginal health in Canadian African, Caribbean, and Black women: A pilot phase 1 clinical trial (2025) · cites this paper as [13]

    The citation is attached to the HIV-risk clause, not the preceding statement about prevalence in ACB communities. The Results (BV-HIV association) support an increased risk of HIV acquisition with BV, but report a relative risk of 1.61, not a consistent 2–5-fold increase. The Discussion assigns a relative risk of 2–5 to other sexually transmitted infections. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • BV is associated with an increased risk of HIV infection in women, possibly by as much as 60%, and increased HIV shedding.

    “BV is associated with an increased risk of HIV infection in women, possibly by as much as 60% (Atashili et al., 2008), and increased HIV shedding (Bolton et al., 2008), therefore BV treatment may help to reduce HIV transmission by various means.”

    From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Atashili et al., 2008

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Cites

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1 of the 55 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Marrazzo, 2003, Bacterial vaginosis, Curr Treat Options Infect Dis, 5, 63

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Authors
Atashili, J., Poole, C., Ndumbe, P. M., Adimora, A. A., & Smith, J. S.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Université de Yaoundé I (CM)
Corresponding author
Smith, Jennifer S
ORCID
Venue
AIDS
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-07-31
Volume
22
Issue
12
Pages
1493-1501
ISSN
0269-9370 (ISSN-L)
DOI
10.1097/qad.0b013e3283021a37
PMC
PMC2788489
OpenAlex
W2044148516
Cited by
706
References
55
Citations by year
2026: 33 · 2025: 44 · 2024: 35 · 2023: 48 · 2022: 48 · 2021: 37 · 2020: 61 · 2019: 43 · 2018: 36 · 2017: 46 · 2016: 42 · 2015: 41 · 2014: 36 · 2013: 32 · 2012: 44
FWCI
3.73
Type
journal article
Language
en
Open access
Locations
  • AIDS (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Fogarty International Center (D43TW001039, 5 D43 TW01039-08)
  • National Institute of Environmental Health Sciences (P30ES10126), P30ES010126)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
Keywords
bacterial vaginosis, HIV acquisition, HIV incidence, HIV prevalence, women, sexual risk behavior, vaginal microbiology, HIV risk factors
MeSH terms
Adolescent, Adult, Aged, Female, Humans, Middle Aged, Risk-Taking, Sexual Behavior, HIV Infections, Incidence, Prevalence, Vaginosis, Bacterial

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