Smart S, Singal A, Mindel A
Sexually Transmitted Infections Research Centre, The University of Sydney, Marian Villa, Westmead Hospital, Westmead NSW 2145, Australia.
Sex Transm Infect. 2004 Feb;80(1):58-62. doi: 10.1136/sti.2003.004978.
A number of sexual and social risk factors for bacterial vaginosis (BV) have been identified. However, many previous studies have used small numbers of patients, or highly selected or convenience samples, or poorly defined populations. This study aims to clarify potential sexual and non-sexual risk factors for BV.
Women attending the Sydney Sexual Health Centre with BV, between March 1991 and July 1999, were included. Controls were randomly selected women without BV. Information on the demographics, clinical findings, and sexual and non-sexual risk behaviours were extracted from the clinic database and analysed using SPSS and SAS. A logistic regression model was used to establish which associations with BV persisted.
890 women with BV and 890 controls were studied. Factors that were independently associated with BV were > or =3 male sexual partners in the past 12 months (OR = 1.60, 95% CI: 1.19 to 2.04), at least one female sexual partner in the past 12 months (OR = 2.1, p = 0.003), a past pregnancy (OR = 1.5, p<0.0006), and smoking. In contrast, women with BV were significantly less likely to have used hormonal contraception (OR = 0.60, 95% CI: 0.51 to 0.81) or to have used condoms consistently (OR = 0.5, 95% CI: 0.31 to 0.71) than controls.
Our findings may be important for planning a preventive strategy for BV by discouraging smoking and increasing condom use and hormonal contraception among women.
已确定了一些细菌性阴道病(BV)的性和社会风险因素。然而,许多先前的研究使用的患者数量较少,或采用高度选择或便利样本,或人群定义不明确。本研究旨在阐明BV潜在的性和非性风险因素。
纳入1991年3月至1999年7月期间到悉尼性健康中心就诊的患有BV的女性。对照组为随机选取的无BV的女性。从诊所数据库中提取人口统计学、临床发现以及性和非性风险行为的信息,并使用SPSS和SAS进行分析。采用逻辑回归模型来确定与BV持续存在的关联。
对890名患有BV的女性和890名对照进行了研究。与BV独立相关的因素包括:在过去12个月中有≥3名男性性伴侣(比值比[OR]=1.60,95%置信区间[CI]:1.19至2.04)、在过去12个月中有至少1名女性性伴侣(OR=2.1,p=0.003)、既往怀孕(OR=1.5,p<0.0006)以及吸烟。相比之下,患有BV的女性使用激素避孕的可能性显著低于对照组(OR=0.60,95%CI:0.51至0.81),持续使用避孕套的可能性也显著低于对照组(OR=0.5,95%CI:0.31至0.71)。
我们的研究结果对于通过劝阻吸烟以及增加女性使用避孕套和激素避孕来规划BV预防策略可能具有重要意义。