Bacterial vaginosis associated with high rates of sexually transmitted infections among South African adolescent girls and young women.

PURPOSE: Bacterial vaginosis (BV) is associated with sexually transmitted infections (STIs), and it is highly prevalent among sub-Saharan African women. This study investigated the bacterial vaginosis (BV) prevalence, its effect on human papillomavirus (HPV), Chlamydia trachomatis, Neisseria gonorrhoea, Trachomonas vaginalis, Mycoplasma genitalium and herpes simplex virus 1/2 (HSV1/2) prevalence and associated factors among adolescent girls and young women (AGYW) of Eastern Cape province, South Africa.

METHODS

A total of 212 participants were retrospectively recruited from an HPV educational intervention study in Eastern Cape province. This study used secondary data on BV, HPV, C. trachomatis, N. gonorrhoea, T. vaginalis, M. genitalium and HSV1/2 and questionnaires. Associations between STIs, BV and other factors were assessed using GraphPad Prism version 8.

RESULTS

A proportion of 83.0% (176/212) AGYW were infected with ≥ 1 STI(s), and 44.3% (94/212) had BV. BV-negatives had a significantly lower prevalence of having 3-4 STIs than BV-positives (Prevalence Ratio (PR): 0.22, 95% CI: 0.08-0.57, p = 0.001). Compared to BV-negative with a significant amount of Lactobacillus species, BV-positive AGYW were more likely to have C. trachomatis (PR: 1.8, 95% CI: 1.0-3.2, p = 0.028); T. vaginalis (PR: 8.3, 95% CI: 1.1-62.3, p = 0.011) and vaginal discharge or itching (PR: 2.4, 95% CI: 1.2-4.8, p = 0.013). Smoking (PR: 1.6, 95% CI: 1.1-2.4, p = 0.008), having two lifetime partners (PR: 1.9, 95% CI: 1.2-3.1, p = 0.006), three lifetime partners (PR: 2.6, 95% CI: 1.3-5.2, p = 0.007) and new sexual partners past three-month (PR: 1.8, 1.2-2.7, p = 0.005) were the associated factors of BV.

CONCLUSION

The bacterial vaginosis increased the risk of STIs and coinfection among AGYW. The presence and high amount of Lactobacillus species were associated with decreased risk of STIs. These findings indicate the urgent need to enhance BV and STI prevention, detection and management among AGYW.