2014 年至 2018 年纽约市性健康诊所患者复发性细菌性阴道病的社会人口学和行为预测因素。

Sociodemographic and Behavioral Predictors of Recurrent Bacterial Vaginosis Among Sexual Health Clinic Patients in New York City From 2014 to 2018.

机构信息

From the Columbia University School of Social Work.

Bureaus of Hepatitis, HIV, and Sexually Transmitted Infections.

出版信息

Sex Transm Dis. 2023 Oct 1;50(10):645-651. doi: 10.1097/OLQ.0000000000001844. Epub 2023 Jul 1.

DOI:10.1097/OLQ.0000000000001844

PMID:37432999

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10527966/

Abstract

OBJECTIVE

Bacterial vaginosis (BV) is associated with adverse reproductive outcomes, and recurrence is common. We examined factors associated with BV recurrence using electronic medical record data for patients attending New York City Department of Health and Mental Hygiene sexual health clinics from 2014 to 2018.

METHODS

Clinician-diagnosed BV was defined using a clinical BV diagnosis code based on Amsel criteria. Recurrent BV was defined as any BV diagnosis occurring more than 30 days after the previous diagnosis. Adjusted hazard ratios (AHRs) for the relationship between potential risk factors and recurrent BV were estimated using conditional gap-time models.

RESULTS

The data set contained 14,858 patients with at least one BV diagnosis. Of these, 46.3% (n = 6882) had at least 1 follow-up visit to a sexual health clinic between January 2014 and December 2018. Of those with a follow-up visit, 53.9% (n = 3707) had ≥1 recurrent BV episode, with 33.7% (n = 2317) experiencing recurrence within 3 months. In the multivariable model, using a hormonal intrauterine device (IUD; AHR, 1.31; 95% confidence interval [CI], 1.14-1.49) or copper IUD (AHR, 1.17; 95% CI, 1.01-1.37), having a history of trichomonas (AHR, 1.23; 95% CI, 1.12-1.36), and being non-Hispanic Black (AHR, 1.11; 95% CI, 1.04-1.18) were associated with a higher risk of BV recurrence, whereas using non-IUD hormonal contraception was associated with reduced risk (AHR, 0.88; 95% CI, 0.80-0.98).

CONCLUSIONS

Risk of BV recurrence was increased among patients using an IUD, whereas it was reduced in patients using non-IUD hormonal contraception.

摘要

目的

细菌性阴道病（BV）与不良生殖结局相关，且易复发。本研究使用 2014 年至 2018 年纽约市卫生局性健康诊所的电子病历数据，探讨与 BV 复发相关的因素。

方法

临床医生根据 Amsel 标准诊断 BV，使用基于 BV 临床诊断代码进行定义。复发 BV 定义为上次诊断后 30 天以上任何 BV 诊断。使用条件间隙时间模型估计潜在危险因素与复发性 BV 之间的调整后风险比（AHR）。

结果

数据集包含了 14858 名至少有一次 BV 诊断的患者。其中，46.3%（n=6882）在 2014 年 1 月至 2018 年 12 月期间至少有一次性健康诊所随访。在有随访的患者中，53.9%（n=3707）有≥1 次复发性 BV 发作，33.7%（n=2317）在 3 个月内复发。多变量模型显示，使用激素宫内节育器（IUD；AHR，1.31；95%置信区间[CI]，1.14-1.49）或铜 IUD（AHR，1.17；95% CI，1.01-1.37）、有滴虫病史（AHR，1.23；95% CI，1.12-1.36）和非西班牙裔黑人（AHR，1.11；95% CI，1.04-1.18）与较高的 BV 复发风险相关，而使用非 IUD 激素避孕则与降低风险相关（AHR，0.88；95% CI，0.80-0.98）。