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Among patients presenting for vaginitis evaluation, bacterial vaginosis was found to be strongly associated with increased risk of nonviral sexually transmitted coinfection, as published in O&G Open. Researchers retrospectively studied 1.5 million women who received molecular testing for bacterial vaginosis, vulvovaginal candidiasis, and sexually transmitted infection (STI) from 2022–2024 in the United States. They found bacterial vaginosis was detected in 38.7% of patients and vulvovaginal candidiasis was detected in 28.5% of patients—with 10.8% of patients testing positive for both. Among women with bacterial vaginosis, 12.0% had at least 1 STI, compared with 3.8% of those without bacterial vaginosis. After adjustment for age, geographic region, and vulvovaginal candidiasis, bacterial vaginosis was associated with increased odds of Chlamydia trachomatis (odds ratio [OR] 2.8), Neisseria gonorrhoeae (OR 3.8), Trichomonas vaginalis (OR 3.6), and Mycoplasma genitalium (OR 1.9). However, vulvovaginal candidiasis alone was not associated with increased STI risk. Although the study data did not include the site of testing or care, researchers sourced it from a U.S. national reference laboratory among specimens submitted by healthcare professionals for molecular testing.
Close the gap: The authors say the findings demonstrate the need for comprehensive STI testing in women with bacterial vaginosis to identify concurrent infections and guide treatment. Bundled testing for STIs also represents an opportunity for urgent care centers to close gaps in care, as described in this recent Developing Data feature from the JUCM archive: Missed Opportunities in STI Test Bundling