Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Sex Transm Infect. 2019 Nov;95(7):511-515. doi: 10.1136/sextrans-2018-053824. Epub 2019 Mar 14.
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).
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.
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.
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.
细菌性阴道病（BV）的流行病学有利于与 BV 相关的细菌的性传播。我们在一项对女同性恋者（WSW）的前瞻性研究中检查了 BV （iBV）的潜伏期和危险因素。
使用每日自我采集的阴道拭子，对阴道微生物群正常（无 Amsel 标准和 Nugent 评分 0-3）的 WSW 进行了 90 天的随访，或直到发生 iBV（至少连续 2-3 天 Nugent 评分 7-10）。每日完成性行为和月经日记。估计发生 iBV 的时间。考虑到不同的随访时间和年龄，根据 iBV 状态比较每 100 人天（pd）的性行为发生率（per）。还研究了月经与 iBV 的关系。
在 36 名 WSW 中，平均年龄为 30 岁（SD 8），92%为非裔美国人。第 30 天和第 60 天 iBV 的概率分别为 20%（SD 7%）和 36%（SD 8%）；14 名（39%）在 90 天内发生 iBV。在发生 iBV 的 WSW 与未发生 iBV 的 WSW 相比，发生 iBV 前任何性行为的相对率高 40%（每 100pd 分别为 20.4 和 14.6；p=0.010），与女性发生性行为的比例高 38%（每 100pd 分别为 14.3 和 10.3；p=0.038），手指阴道性交的比例高 57%（每 100pd 分别为 14.3 和 9.1；p=0.005），手指肛门性交的比例高 5.6 倍（每 100pd 分别为 2.9 和 0.5；p<0.001）。与最近没有月经的 WSW 相比，在最近 2 天内有月经的 WSW 发生 iBV 的可能性更大（HR 3.4；p=0.029）。93%的 WSW 在发生 iBV 前的中位数 4 天（95%CI 2 至 6）内有性行为。
在本项以非裔美国人为主要人群的 WSW 队列中，iBV 很常见，并与性行为有关。4 天的潜伏期与其他细菌性性传播感染一致。
