Crowdsourced Analysis of GBS Perinatal Disease as a Sexually Transmissible Infection (STI) Underscores Need for GBS Vaccine and Patient Education regarding GBS as an STI to Be Able to Make Well-Informed Sexual Practice Choices

Background: Information available to prospective parents states that GBS is not a sexually transmitted disease (STD). Both clarification regarding terminology and patient education that GBS is sexually transmissible are necessary for pregnant patients to make well-informed choices regarding their sexual practices in order to possibly reduce risks of GBS infection in both mother and baby.

Methods:  Since 1998 we employed crowdsourcing methods by maintaining an internet-based interest/advocacy sounding board which responded to parents who shared apparent instances of GBS-linked reproductive infections along with “lay” observations/comments and often well-reasoned, documented suggestions regarding GBS disease policies and prevention.

Results:  1) Before their GBS disease experience, even parents who were aware of GBS assumed that GBS was not shared via sexual contact because GBS is not considered an STD. 2) Upon further research after their GBS disease experience, parents learned that GBS can be shared between the GI and GU tracts of couples during sexual contact. 3) Contributors note that a) intrapartum antibiotic prophylaxis (IAP) strategies frequently fail (greater than 60% of early-onset GBS infections occur after GBS NEG maternal screening), and b) a Cochrane Database Analysis calculated a borderline significant benefit ONLY for early-onset GBS disease (CI 0.04-.74, NNT=25). 

Conclusions: Contributors offered observations and reasoned suggestions that in practice a) recommended IAP approaches require improvement, b) pregnant patients need to be educated that GBS is sexually transmissible to be able to make well-informed choices regarding their sexual practices to possibly help reduce the risk of GBS disease in both mother and baby, c) pregnant patients need to be educated that intercourse (vaginal, anal, or with new partner) may inoculate the vagina after being screened GBS NEG and that condom usage may reduce any new vaginal colonization,  and d) GBS vaccination is much-needed to close the gaps in GBS disease prevention.