Factors associated with bacterial vaginosis in women with homosexual, bisexual and heterosexual practices

Ignacio, Mariana Alice de Oliveira; Buesso, Thayná Santos; Morales, Julia Andrade Pessoa; Silva, Mariana de Castro; Silva, Marcia Guimaraes da; Duarte, Marli Teresinha Cassamassimo

doi:10.1016/j.bjid.2023.102760

Acessibilidade / Reportar erro

Brasil

Brazilian Journal of Infectious Diseases

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Braz J Infect Dis 27 (3) • 2023 • https://doi.org/10.1016/j.bjid.2023.102760 copy

Factors associated with bacterial vaginosis in women with homosexual, bisexual and heterosexual practices

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

The factors associated with bacterial vaginosis in women with homosexual, bisexual and heterosexual practices are still poorly explored. Thus, the aim of this study was to analyze the factors associated with bacterial vaginosis in women with different sexual practices.

Methods

Cross-sectional study that included 453 women, 149 Women with Homosexual practice (WSW); 80 bisexual Women (WSWM) and 224 Women with heterosexual practice (WSM). The diagnosis of bacterial vaginosis was performed by microscopic examination of the vaginal smears stained by Gram method and classified according to the Nugent et al. (1991) score. Data analysis was performed by Cox multiple regression.

Results

Bacterial vaginosis was associated to years of education among WSW (0.91 [95% CI 0.82‒0.99]; p= 0.048) and non-white skin color (2.34 [95% CI 1.05‒5.19]; p= 0.037) between WSWM. Changing partners in the last 3-months (2.09 [95% CI 1.14‒3.82]; p= 0.017), inconsistent use of condoms (2.61 [95% CI 1.10‒6.20]; p= 0.030) and positive diagnosis of Chlamydia trachomatis (2.40 [95% CI 1.01‒5.73]; p= 0.048) were associated with bacterial vaginoses only in WSH.

Conclusions

The factors associated to bacterial vaginosis differ between different sexual practices, suggesting that the type of sexual partner may influence the risk of developing this classic dysbiosis.

Keywords
Bacterial vaginosis; Female homosexuality; Heterosexuality; Sexual and gender minorities; Sexual behavior

Caracteristics	WSW (n= 149)		WSWM (n= 80)		WSM (n= 224)		Total (n= 453)		p^a a χ2 test or Fisher's exact test and Mann-Whitney test.
Caracteristics	n	%	n	%	n	%	n	%
Ethnicity									0.324
White	105	70.5	62	77.5	172	76.8	339	74.8
Non-white	44	29.5	18	22.5	52	23.2	114	25.2
Lives with partner									0.001
Yes	40	26.8	05	6.2	49	21.9	94	20.8
No	109	73.2	75	93.8	175	78.1	359	79.2
Remunerated activity									0.000
Yes	109	73.2	37	46.2	149	66.5	295	65.1
No	40	26.8	43	53.8	75	33.5	158	34.9
Per capita family income									0.047
< 1/2 minimum salary^b b Minimum salary in force in Brazil at the time of data collection.	13	8.7	08	10.0	08	3.6	29	6.4
> 1/2 minimum salary^b b Minimum salary in force in Brazil at the time of data collection.	136	91.3	72	90.0	216	96.4	424	96.6
Use of tobacco									0,000
Yes	74	49.7	44	55.0	62	27.7	180	39.7
No	75	50.3	36	45.0	162	72.3	273	60.3
Changing sexual partners in the last three months									0.000
Yes	15	10.1	36	45.0	47	21.0	98	21.6
No	134	89.9	44	55.0	177	79.0	355	78.4
Use of sexual accessories									0.000
Yes	51	34.2	19	23.8	22	9.8	92	20.3
No	98	65.8	61	76.2	202	90.2	361	79.7
Vaginal penetration									0.000
Yes	129	86.6	77	96.3	224	100.0	430	94.9
No	20	13.4	03	3.7	00	00	23	5.1
Anal penetration									0.061
Yes	24	16.1	20	25.0	59	26.3	103	22.7
No	125	83.9	60	75.0	165	73.7	350	77.3
Oral sex									0.208
Yes	143	96.0	80	100.0	217	96.9	440	97.1
No	06	4.0	00	00	07	3.1	13	2.9
Inconsistent use of condom^c c Inconsistent use: did not use condoms in all vaginal and anal intercourse.									0.015
Yes	26	17.4	07	8.7	52	23.2	85	18.8
No	123	82.6	73	91.3	172	76.8	368	81.2
Vaginal douche									0.015
Yes	23	15.4	09	11.3	14	6.3	46	10.2
No	126	84.6	71	88.7	210	93.7	407	89.8
HPV									0.000
Positive	59	39.6	54	67.5	129	57.6	242	53.4
Negative	90	60.4	26	32.5	95	42.4	211	46.6
C. trachomatis									0.606
Positive	05	3.4	05	6.3	11	4.9	21	4.6
Negative	144	96.6	75	93.7	213	95.1	432	95.4
Bacterial vaginosis									0.013
Positive	53	35.6	29	36.3	52	23.2	134	29.6
Negative	96	64.4	51	63.7	172	76.8	319	70.4
Attend primary health care units									0.000
Yes	89	59.7	54	67.5	185	82.6	328	72.4
No	60	40.3	26	32.5	39	17.4	125	27.6
Gynecological appointment in the last year									0.001
Yes	75	50.3	48	60.0	155	69.2	278	61.4
No	74	49.7	32	40.0	69	30.8	175	38.6

Variables	WSW			WSWM			WSM
Variables	PR	95% CI	p	PR	95% CI	p	PR	95% CI	p
Non-white skin color	1.03	0.57‒1.85	0.916	2.10	0.99‒4.45	0.052	1.34	0.73‒2.44	0.338
Education	0.93	0.84‒1.02	0.135	0.93	0.79‒1.08	0.356	0.93	0.86‒1.01	0.100
Do not live with the partner	1.02	0.55‒1.88	0.944	22.15	0.02‒17,188.43	0.362	1.54	0.72‒3.27	0.261
Do not have remunerated activity	1.17	0.65‒2.11	0.583	0.92	0.44‒1.91	0.827	1.34	0.77‒2.34	0.293
Per capita family income < ½ minimum salary^a a Minimum salary in force in Brazil at the time of data collection.	1.59	0.71‒3.52	0.252	1.87	0.71‒4.91	0.201	2.25	0.81‒6.24	0.119
Use of tobacco	1.54	0.89‒2.67	0.122	1.81	0.82‒3.99	0.136	0.96	0.52‒1.77	0.903
Changing sexual partners in the last three months	1.14	0.48‒2.66	0.762	1.73	0.82‒3.62	0.145	1.82	1.02‒3.26	0.041
Sexual accessories	1.71	1.00‒2.94	0.050	1.44	0.65‒3.17	0.359	1.66	0.78‒3.54	0.182
Receive vaginal penetration	3.95	0.96‒16.23	0.057	21.28	0.00‒106,844.14	0.482	1.13	0.62‒2.06	0.682
Receive anal penetration	0.79	0.35‒1.75	0.567	2.11	1.01‒4.43	0.047	21.07	0.02‒22,141.85	0.391
Receive oral sex	2.18	0.30‒15.78	0.440	‒	‒	‒	2.31	0.99‒5.42	0.053
Inconsistent use of condom^b b Inconsistent use: did not use condoms in all vaginal and anal intercourse.	1.38	0.62‒3.07	0.418	0.83	0.25‒2.74	0.762	0.91	0.28‒2.94	0.886
Vaginal douche	1.27	0.64‒2.53	0.490	2.05	0.83‒5.05	0.115	1.00	0.57‒1.74	0.988
Positive diagnosis of HPV	1.70	0.99‒2.93	0.052	2.31	0.88‒6.05	0.088	2.52	1.07‒5.91	0.033
Positive diagnosis for C. trachomatis	2.35	0.84‒6.51	0.100	1.73	0.52‒5.71	0.368	0.96	0.52‒1.77	0.903
Attend primary health care units	0.70	0.39‒1.24	0.226	0.66	0.28‒1.54	0.340	0.86	0.40‒1.83	0.700
Gynecological appointment in the last year	0.97	0.57‒1.67	0.929	1.21	0.58‒2.53	0.596	1.64	0.95‒2.85	0.075

Variables	WSW			WSWM			WSM
Variables	PR	95% CI	p	PR	95% CI	p	PR	95% CI	p
Non-White skin color	‒	‒	‒	2.34	1.05‒5.19	0.037	‒	‒	‒
Education	0.91	0.82‒0.99	0.048	‒	‒	‒	0.96	0.88‒1.04	0.310
Per capita family income < ½ minimum salary^a a Minimum salary in force in Brazil at the time of data collection.	‒	‒	‒	‒	‒	‒	2.02	0.66‒6.12	0.216
Use of tobacco	1.35	0.77‒2.36	0.297	1.83	0.77‒4.36	0.170	‒	‒	‒
Changing sexual partners in the last three months	‒	‒	‒	1.17	0.51‒2.65	0.711	2.09	1.14‒3.82	0.017
Sexual accessories	1.64	0.95‒2.83	0.076	‒	‒	‒	1.91	0.89‒4.12	0.098
Receive vaginal penetration	3.57	0.86‒14.89	0.080	‒	‒	‒	‒	‒	‒
Receive anal penetration	‒	‒	‒	1.88	0.89‒3.98	0.099	‒	‒	‒
Inconsistent use of condom^b b Inconsistent use: did not use condoms in all vaginal and anal intercourse.	‒	‒	‒	‒	‒	‒	2.61	1.10‒6.20	0.030
Vaginal douche	‒	‒	‒	1.88	0.72‒4.92	0.196	‒	‒	‒
Positive diagnosis of HPV	1.62	0.94‒2.80	0.082	2.04	0.76‒5.44	0.155	‒	‒	‒
Positive diagnosis for C. trachomatis	2.05	0.72‒5.82	0.178	‒	‒	‒	2.40	1.01‒5.73	0.048
Gynecological appointment in the last year	‒	‒	‒	‒	‒	‒	1.65	0.94‒2.89	0.083

Brazilian Society of Infectious Diseases Rua Augusto Viana, SN, 6º., 40110-060 Salvador - Bahia - Brazil, Telefax: (55 71) 3283-8172, Fax: (55 71) 3247-2756 - Salvador - BA - Brazil
E-mail: bjid@bjid.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] ⁎ Corresponding author. E-mail address: marli.t.duarte@unesp.br (M.T.C.Duarte).