Characterization of the Clinical Manifestations of Bacterial Vaginosis at a Tertiary Care Infectious Diseases Vaginitis Clinic in the United States.

BACKGROUND

Bacterial vaginosis (BV) is common and characterized by heterogeneous presentations. We aimed to determine BV subtype prevalence among women attending a United States infectious diseases vaginitis specialty clinic at initial and follow-up visits and identify factors associated with BV subtypes.

METHODS

Medical records from adult patients were reviewed, including demographics, visit frequency, STI history, symptoms, and diagnoses. Chi-square, Fisher exact, and Wilcoxon rank-sum tests compared women with and without BV. Modified Poisson models with generalized estimating equations assessed associations between characteristics and BV subtypes.

RESULTS

Between June 2021 and December 2024, 149 patients were evaluated; 49 (32.9%) had BV at the initial visit. Recurrent BV was most common (n = 27, 55.1%), followed by uncomplicated symptomatic BV (n = 18, 36.7%), asymptomatic BV (n = 3, 6.1%), and refractory BV (n = 1, 2.0%). Black women were more likely than White women to have BV (adjusted relative risk [aRR]: 3.92, 95% confidence interval [CI]: 1.66-9.27), as were women with a pregnancy history (aRR: 2.37, 95% CI: 1.23-5.03). No predictors were identified for uncomplicated BV. Recurrent BV was associated with younger age (≤25 y; aRR: 4.29, 95% CI: 1.06-17.29), higher body mass index (BMI) (aRR: 3.48 for BMI 25-29.9; aRR: 3.06 for BMI ≥30), STI history (aRR: 2.19, 95% CI: 1.05-4.57), and a pregnancy history (aRR: 3.14, 95% CI: 1.22-8.06).

CONCLUSIONS

High BV prevalence and frequent recurrent BV were observed. Race, obesity, STI history, and a pregnancy history were associated with recurrent BV. Further research is needed to characterize factors influencing recurrent BV to optimize sexual health outcomes.