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Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies
Open accessAbstract
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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“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]
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“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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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Impacts of biodiversity on the emergence and transmission of infectious diseases
Keesing, F., Belden, L. K., Daszak, P., Dobson, A., Harvell, C. D., Holt, R. D., Hudson, P., Jolles, A., Jones, K. E., Mitchell, C. E., et al. (2010) · Nature · doi:10.1038/nature09575 · Cited by 2,043
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The Vaginal Microenvironment: The Physiologic Role of Lactobacilli
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Metadata
- 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
- Venue
- AIDS
- Published
- 2008-07-31
- Volume
- 22
- Issue
- 12
- Pages
- 1493-1501
- ISSN
- 0269-9370 (ISSN-L)
- 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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