Cumulative Lifetime Violence and Bacterial Vaginosis Infection in Sexually Transmitted Infections: Findings From a Retrospective Cohort Study Among Black Women at Risk for HIV

Yordanos Tesfai; Marguerite B Lucea; Erica Chan; Theresa Asuquo; Helen Zhu; Tommi L Gaines; Jacquelyn C Campbell; Jamila K Stockman; Kiyomi Tsuyuki

doi:10.1016/j.focus.2023.100180

Cumulative Lifetime Violence and Bacterial Vaginosis Infection in Sexually Transmitted Infections: Findings From a Retrospective Cohort Study Among Black Women at Risk for HIV

AJPM Focus. 2023 Dec 24;3(2):100180. doi: 10.1016/j.focus.2023.100180. eCollection 2024 Apr.

Authors

Yordanos Tesfai¹, Marguerite B Lucea², Erica Chan¹, Theresa Asuquo³, Helen Zhu⁴, Tommi L Gaines⁴, Jacquelyn C Campbell⁵, Jamila K Stockman⁴, Kiyomi Tsuyuki⁴

Affiliations

¹ Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
² Department of Nursing, College of Health Professions, Towson University, Towson, Maryland.
³ Program in Medical Education - Health Equity (PRIME-HEQ), Department of Medicine, University of California, San Diego, La Jolla, California.
⁴ Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California.
⁵ School of Nursing, Johns Hopkins University, Baltimore, Maryland.

Abstract

Introduction: Bacterial vaginosis is the most common vaginal condition among women of reproductive age and has been associated with sexually transmitted infections. This study examines the association between cumulative lifetime violence exposure, bacterial vaginosis, and sexually transmitted infections among Black women at risk for HIV.

Methods: HIV-negative Black women in a retrospective cohort study (N=230) completed survey questions on cumulative violence (exposure to sexual or physical abuse before age 18 years and exposure to intimate partner violence or sexual violence [partner or other] after age 18 years and past year), bacterial vaginosis (lifetime and past year), and sexually transmitted infection diagnosis (lifetime and past year). Logistic regression models estimated the associations between cumulative violence, bacterial vaginosis, and sexually transmitted infections. Bacterial vaginosis was examined as a moderator in the association between cumulative violence and sexually transmitted infections.

Results: Many women reported cumulative violence exposure (40%), lifetime bacterial vaginosis diagnosis (53%), and lifetime sexually transmitted infection diagnosis (73%). Cumulative violence experience was significantly associated with increased adjusted odds of lifetime bacterial vaginosis diagnosis (AOR=1.98; 95% CI=1.10, 3.54). Lifetime bacterial vaginosis diagnosis (AOR=2.76; 95% CI=1.45, 5.22) and past-year bacterial vaginosis diagnosis (AOR=2.16; 95% CI=1.14, 4.10) were significantly associated with increased odds of lifetime sexually transmitted infection diagnosis. Lifetime bacterial vaginosis diagnosis (AOR=2.10; 95% CI=1.19, 3.70) and past-year bacterial vaginosis diagnosis (AOR=3.00; 95% CI=1.70, 5.31) were significantly associated with past-year sexually transmitted infection diagnosis. Lifetime bacterial vaginosis infection significantly increased the odds of lifetime sexually transmitted infection diagnosis with increasing cumulative violence exposure.

Conclusions: Our findings support educating and screening Black women who experience cumulative violence for bacterial vaginosis to reduce the risk of untreated bacterial vaginosis and sexually transmitted infections.

Keywords: Bacterial vaginosis; Black women; cumulative violence; physical abuse; sexual abuse; sexually transmitted infections.

Abstract

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