The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006 - 10:00 AM

Prevalence of bacterial vaginosis in the United States, 2001-2002

Emilia H. Koumans1, Maya R. Sternberg2, Geraldine McQuillan3, Carol Bruce4, Juliette S. Kendrick5, Madeline Y. Sutton6, and Lauri Markowitz1. (1) Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-02, Atlanta, GA, USA, (2) Division of STD Prevention, CDC, 1600 Clifton Road, Mailstop E-02, Atlanta, GA, USA, (3) NHANES, NCHS, Washington, DC, DC, USA, (4) DRH, CDC, Atlanta, GA, USA, (5) Div of Reproductive Health, CDC, MS K-20, Atlanta, GA, USA, (6) DSTDP, CDC, 1600 Clifton Road, MS E-02, Atlanta, GA, USA

In bacterial vaginosis (BV) predominant lactobacilli are replaced by anaerobes and gram negative bacteria. BV is associated with acquisition of STI, adverse reproductive outcomes, and HIV infection.

To describe the prevalence of and factors associated with BV in the United States using the National Health and Nutrition Examination Survey (NHANES) 2001-2002.

Self-collected vaginal swabs were used to prepare a Gram stained slide from women 14-49 years of age. BV was defined as a score of 7-10 using Nugent's criteria. SUDAAN software was used for analysis and logistic regression to account for the complex survey design.

Of 2479 women who completed the interview, 1999 (81%) provided an interpretable specimen. The overall prevalence of BV was 27.4% (95% confidence interval 24.5%-30.7%) and significant differences in prevalence were found across race/ethnic groups: 50.3% non-Hispanic blacks, 28.8% Mexican Americans, and 22.4% non-Hispanic whites. Prevalence was 35.9% among women with onset of sex <16 years, 26.8% with onset 16-17 years, 22.8% with onset >17 years, and 17.0% among women who had never had sex. Prevalence was 17.5% for those with one lifetime sex partner, 25.7% for those with 2, 23.6% for those with 3-5 and 36.8% for 6 or more. Women who had douched in the previous month had a prevalence of 45.2% compared with 23.3% for those who had not douched (p<0.01). Prevalence was associated with low educational attainment, poverty, smoking, high body mass index, and having been pregnant. Differences by race/ethnicity remained after adjusting for these significant factors. Vaginal symptoms were reported by 17% of women with BV.

This is the first report of BV prevalence from a nationally representative sample. BV prevalence is high, few women had symptoms, and racial and ethnic disparities remain significant after adjusting for behavioral factors.

Further research could identify which women with BV are at risk for complications and to identify reasons for racial and ethnic disparities.