TITLE

Vaginal Lactobacilli, Microbial Flora, and Risk of Human Immunodeficiency Virus Type 1 and Sexually Transmitted Disease Acquisition

AUTHOR(S)
Martin Jr., Harold L.; Richardson, Barbra A.; Nyange, Patrick M.; Lavreys, Ludo; Hillier, Sharon L.; Chohan, Bhavna; Mandaliya, Kishorchandra; Ndinya-Achola, J. O.; Bwayo, Job
PUB. DATE
December 1999
SOURCE
Journal of Infectious Diseases;12/1/99, Vol. 180 Issue 6, p1863
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
A prospective cohort study was conducted to examine the relationship between vaginal colonization with lactobacilli, bacterial vaginosis (BV), and acquisition of human immunodeficiency virus type 1 (HIV-1) and sexually transmitted diseases in a population of sex workers in Mombasa, Kenya. In total, 657 HIV-1-seronegative women were enrolled and followed at monthly intervals. At baseline, only 26% of women were colonized with Lactobacillus species. During follow-up, absence of vaginal lactobacilli on culture was associated with an increased risk of acquiring HIV-1 infection (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.2-3.5) and gonorrhea (HR, 1.7; 95% CI, 1.1-2.6), after controlling for other identified risk factors in separate multivariate models. Presence of abnormal vaginal flora on Gram's stain was associated with increased risk of both HIV-1 acquisition (HR, 1.9; 95% CI, 1.1-3.1) and Trichomonas infection (HR, 1.8; 95% CI, 1.3-2.4). Treatment of BV and promotion of vaginal colonization with lactobacilli should be evaluated as potential interventions to reduce a woman's risk of acquiring HIV-1, gonorrhea, and trichomoniasis.
ACCESSION #
5147887

 

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