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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Additional file 4 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
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Additional file 2 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643529
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Additional file 1 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643526
Additional file 1 of Shifts in microbial diversity, composition, and functionality in the gut and genital microbiome during a natural SIV infection in vervet monkeys
Jasinska, A. J., Dong, T. S., Lagishetty, V., Katzka, W. R., Jacobs, J. P., Schmitt, C. A., Cramer, J. D., Ma, D., Coetzer, W. G., Grobler, J. P., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13203457
Additional file 7 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643547
Additional file 3 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643535
Additional file 1 of Lactic acid from vaginal microbiota enhances cervicovaginal epithelial barrier integrity by promoting tight junction protein expression
Delgado-Diaz, D. J., Jesaveluk, B., Hayward, J. A., Tyssen, D. P., Alisoltani, A., Potgieter, M. G., Bell, L., Ross, E. J., Iranzadeh, A., Allali, I., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20762886
Additional file 3 of Shifts in microbial diversity, composition, and functionality in the gut and genital microbiome during a natural SIV infection in vervet monkeys
Jasinska, A. J., Dong, T. S., Lagishetty, V., Katzka, W. R., Jacobs, J. P., Schmitt, C. A., Cramer, J. D., Ma, D., Coetzer, W. G., Grobler, J. P., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13203463
Additional file 9 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643553
Additional file 1 of Composition of the vaginal microbiota during pregnancy in women living in sub-Saharan Africa: a PRISMA-compliant review
Juliana, N. C. A., Peters, R. P. H., Al‐Nasiry, S., Budding, A. E., Morré, S. A., & Ambrosino, E. (2021) · Figshare · doi:10.6084/m9.figshare.16570205
Additional file 6 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643544
Additional file 2 of Composition of the vaginal microbiota during pregnancy in women living in sub-Saharan Africa: a PRISMA-compliant review
Juliana, N. C. A., Peters, R. P. H., Al‐Nasiry, S., Budding, A. E., Morré, S. A., & Ambrosino, E. (2021) · Figshare · doi:10.6084/m9.figshare.16570208
Additional file 5 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643541
Additional file 1 of Prevalence of Mycoplasma genitalium infection in women with bacterial vaginosis
Nye, M. B., Harris, A. B., Pherson, A. J., & Cartwright, C. P. (2020) · Figshare · doi:10.6084/m9.figshare.12038004
Additional file 8 of Integrating compositional and functional content to describe vaginal microbiomes in health and disease
Holm, J. B., France, M., Gajer, P., Ma, B., Brotman, R. M., Shardell, M., Forney, L. J., & Ravel, J. (2024) · Figshare · doi:10.6084/m9.figshare.26643550
Changes in the Genital Microbiome and Inflammation Among Women Using 30-Day L. Rhamnosus/L. Reuteri Probiotic in Combination with Intravaginal Estradiol: Findings from a Pilot, Open-Label, Phase I Clinical TrialPreprint
Dabee, S., Niazy, M., Gill, B., Wessels, J. M., Hayes, C. L., Nazli, A., Ratcliffe, J., Wokuri, J., Reid, G., Kaul, R., et al. (2025) · medRxiv · doi:10.64898/2025.12.03.25341486
Diagnostic accuracy of an enzyme-based point-of-care test versus Nugent score for bacterial vaginosis among pregnant women attending routine antenatal care in Zambia
Sorano, S., Chaponda, E. B., Mirandola, M., Chikwanda, E., Mwewa, V., Mulenga, J., Chaponda, M., Ghilardi, L., Harding-Esch, E. M., Smith, C. E., et al. (2026) · BMC Infectious Diseases · doi:10.1186/s12879-026-12714-y
Characteristics associated with Lactobacillus-depleted vaginal microbiota in women with different sexual behavior
Ignácio, M. A. D. O., Marconi, C., Bidinotto, L. T., Balsanelli, E., Belleti, R., da Silva, M. G., & Duarte, M. T. C. (2026) · Scientific Reports · doi:10.1038/s41598-025-34977-2
Evidence from a broad-range PNA probe links several Prevotella species to bacterial vaginosis
Mulinde, T., Sousa, L. G. V., Castro, J., George, S. D., Muzny, C. A., & Cerca, N. (2026) · PeerJ · doi:10.7717/peerj.20902 · Cited by 1
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Ménard, J.-P. (2010) · doi:10.70675/7380d3d0z9cdbz4207z8998z7697ab3a73fd
Génotoxicité de prophylaxies antirétrovirales administrées à des nourrissons nés de mères infectées par le Virus de l'Immunodéficience Humaine pour prévenir sa transmission par l'allaitement
Anouilh, A. (2020) · theses.fr (ABES) · doi:10.70675/fbe3fe60z4c6bz4f53za800zb4cf87d21988
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van Eijk, A. M., Quinn-Savory, A., Zulaika, G., Skinner, A., Mason, L., Green, S. J., Phillips‐Howard, P. A., & Mehta, S. D. (2026) · EBioMedicine · doi:10.1016/j.ebiom.2026.106307
Bacteriophage-Based Therapeutics for Bacterial Sexually Transmitted Infections: From Biological Barriers to Translational Strategies
Syrym, N. S., Yespembetov, B., Kokanov, S. K., Куралбаевич, Н. А., Bulatov, Y. A., Abdimukhtar, A. R., Toleukhan, A. T., Serikbay, Y., Terebay, A. A., Anarbekova, A. M., et al. (2026) · Pathogens · doi:10.3390/pathogens15060559
Detection of Genital Pathogens and Co-Infections by Multiplex RT-qPCR: Associations with HIV Positivity and Demographic Factors
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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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Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies

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