Bacterial vaginosis in virginal and sexually active adolescent females: evidence against exclusive sexual transmission.

Sixty-eight sexually active and 52 virginal asymptomatic adolescent girls were evaluated for bacterial vaginosis and various laboratory indicators of bacterial vaginosis in a 3-month observational noninterventive study. Sixteen of 120 (13%) subjects had bacterial vaginosis during the study. There was no significant difference in the prevalence of bacterial vaginosis or in the prevalence of isolation of Gardnerella vaginalis between the sexually active and virginal groups. Only a few cases of bacterial vaginosis (one of eight), wet mount clue cells (four of 11), sniff tests (two of eight), and abnormal vaginal fluid succinate/lactate ratios (none of 6) persisted for 3 months in the absence of therapy. These results are discussed in light of several recent reports that suggest using the isolation of G. vaginalis or the diagnosis of bacterial vaginosis as evidence of sexual abuse in children. It is concluded that bacterial vaginosis should not be considered an exclusively sexually transmitted disease. The presence of the condition is neither proof of sexual activity nor warrants male sexual partner therapy. In addition, therapy seems unwarranted for the incidental finding of bacterial vaginosis in the patient without symptoms.