Incubation period and risk factors support sexual transmission of bacterial vaginosis in women who have sex with women.
Open accessAbstract
OBJECTIVE: The epidemiology of bacterial vaginosis (BV) favours sexual transmission of BV-associated bacteria. We examined incubation period and risk factors for incident BV (iBV) in a prospective study of women who have sex with women (WSW). METHODS: Using daily self-collected vaginal swabs, WSW with normal vaginal microbiota (no Amsel criteria and a Nugent score of 0-3) were followed for 90 days or until iBV (Nugent score 7-10 on at least 2-3 consecutive days). Daily diaries of sexual activity and menses were completed. Time to iBV was estimated. Accounting for differing lengths of follow-up and age, rates of sexual activities (per 100 person-days (pd)) were compared according to iBV status. The relationship between menses and iBV was also investigated. RESULTS: Of the 36 WSW, the mean age was 30 years (SD 8) and 92% were African American. The probability of iBV at 30 and 60 days was 20% (SD 7%) and 36% (SD 8%), respectively; 14 (39%) developed iBV by 90 days. In WSW with iBV versus those without iBV, the relative rate of any sexual activity prior to iBV was 40% higher (20.4 vs 14.6 per 100 pd; p=0.010), sex with a woman was 38% higher (14.3 vs 10.3 per 100 pd; p=0.038), digital-vaginal sex was 57% higher (14.3 vs 9.1 per 100 pd; p=0.005) and digital-anal sex was 5.6 times higher (2.9 vs 0.5 per 100 pd; p<0.001). iBV was more likely for those WSW with menses in the prior 2 days as compared with those without recent menses (HR 3.4; p=0.029). Sexual activity occurred in 93% WSW at a median of 4 days (95% CI 2 to 6) prior to iBV. CONCLUSION: iBV was common and associated with sexual activity in this cohort of predominantly African American WSW. An incubation period of 4 days is consistent with other bacterial STIs.
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Evidence continues to support the association of such sexual behaviors as having a new partner, having a partner with BV, having receptive oral sex, and having digital-vaginal and digital-anal sex with incident BV.
“Evidence continues to support the association of such sexual behaviors as having a new partner, having a partner with BV, having receptive oral sex, and having digital-vaginal and digital-anal sex with incident BV (313,314).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [313]
The Results report significant associations of digital-vaginal and digital-anal sex with incident BV among women who have sex with women. The Introduction reports an association with a new female partner with a BV history, but its separate finding about a partner with BV concerns prevalent BV. The Discussion reports a dose-response association for receptive oral sex in an earlier study, while noting that other measures did not show it. Thus the source supports much of the sentence, but not every behavior as an unqualified association with incident BV. (LLM, conf=0.86)
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Sexually Transmitted Infections Treatment Guidelines, 2021
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Self-citation
- Authors
- Muzny, C. A., Lensing, S. Y., Aaron, K. J., & Schwebke, J. R.
- Affiliations
- University of Alabama at Birmingham (US)
- University of Arkansas for Medical Sciences (US)
- Corresponding author
- Muzny, Christina Ann
- Venue
- Sexually Transmitted Infections
- Publisher
- BMJ
- Published
- 2019-03-14
- Volume
- 95
- Issue
- 7
- Pages
- 511-515
- ISSN
- 0007-134X (ISSN-L)
- 1368-4973
- 1472-3263
- PMC
- PMC7265897
- OpenAlex
- W2921973735
- Cited by
- 43
- References
- 29
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 5 · 2023: 7 · 2022: 3 · 2021: 5 · 2020: 6 · 2019: 6
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sexually Transmitted Infections (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (K23AI106957)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
- Keywords
- bacterial vaginosis, women who have sex with women, sexual transmission, incubation period, risk factors, vaginal microbiota, sexual activity, menstrual cycle, African American women, Nugent score, Amsel criteria, vaginal swabs, health disparities
- MeSH terms
- Sexual and Gender Minorities, Adolescent, Adult, Female, Humans, Middle Aged, Prospective Studies, Risk Factors, Time Factors, Vaginosis, Bacterial, Disease Transmission, Infectious, Young Adult
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