Cited by 713Reproductive tract infections researchHIV/AIDS Research and InterventionsCervical Cancer and HPV Research

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

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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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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: Poole, Charles
Adimora, Adaora A
Smith, Jennifer S
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: green
www.ncbi.nlm.nih.gov
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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