HPV Virus Research - Risks

Chiaffarino F, Parazzini F, De Besi P, Lavezzari M. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milano, Italy.

OBJECTIVE: To analyse risk factors for bacterial vaginosis (BV). STUDY DESIGN: We conducted a case-control study on risk factors for BV, in several first-level gynecological centers in Italy. Cases were women aged 18-70 years with confirmed diagnosis of BV (using test for proline iminopeptidase (PIP) activity). Control were the first patients observed in the same center without any symptom suggesting vaginal infection, and a negative PIP activity test. A total of 476 cases and 450 controls entered the study. RESULTS: The number of sexual partners in the month before interview, but not the number of intercourses, was associated with an increased risk of BV. The risk of BV with vaginal douching or tight jeans/trousers once or more a week was 2.0 (95% CI 1.0-3.9) and 1.5 (95% CI 1.0-2.2), respectively, compared to never users. CONCLUSION: The findings are consistent with previous data and suggest that daily habits play an important role in risk of BV.

Perspect Sex Reprod Health. 2005 Mar;37(1):6-12.

Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women.

Marrazzo JM, Coffey P, Elliott MN. Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA.

CONTEXT: Sexually transmitted diseases (STDs) can be spread between female sex partners, probably through the exchange of cervicovaginal fluid and direct mucosal contact. Additionally, lesbians have a high prevalence of bacterial vaginosis, which may represent an STD in this population. However, few data on sexual practices or perceived STD risk among lesbians are available to guide development of interventions aimed at reducing the risk. METHODS: To inform the development of a safer-sex intervention for women who have sex with women, focus group discussions were conducted with 23 lesbian and bisexual women aged 18-29. Topics included sexual practices, STD transmission and prevention, and knowledge about bacterial vaginosis. RESULTS: Although six participants had had bacterial vaginosis and three an STD, women reported little use of preventive measures with female partners (washing hands, using rubber gloves and cleaning sex toys). Participants said that vaginal penetrative practices using sex toys and fingers or hands are common, and that partners frequently share sex toys during a sexual encounter, generally without condoms. Knowledge of potential for STD transmission between women, and of bacterial vaginosis, was limited. Participants viewed use of barrier methods (gloves or condoms) as acceptable, provided that there is a reason (usually STD-focused) to use them and that they are promoted in the context of sexual health and pleasure. CONCLUSIONS: Safer-sex messages aimed at lesbian and bisexual women should emphasize the plausibility of STD transmission between women, personal responsibility and care for partners' well-being; should target common sexual practices; and should promote healthy sexuality.

J Coll Physicians Surg Pak. 2005 May;15(5):270-2.

Frequency and diagnosis of bacterial vaginosis.

Luni Y, Munim S, Qureshi R, Tareen AL. Department of Obstetrics & Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.

Objective: To determine the frequency of bacterial vaginosis (BV) in women with vaginal discharge, and to compare different diagnostic tests for its diagnosis. Design: Cross-sectional study. Place and Duration of Study: The Aga Khan University Hospital from June 1998 to May 2000. patients and Methods: All women attending the Obstetrics and Gynecology clinics at The Aga Khan University Hospital, with the complaints of vaginal discharge, were examined with the help of a speculum. The vaginal pH was measured, samples for bacterial cultures were obtained. A slide was prepared for the gram's stain and Whiff-test was also performed. BV was diagnosed, when the vaginal discharge fulfilled at least three of the composite clinical criteria (Amsel's criteria), a standard method for the diagnosis of bacterial vaginosis: homogenous (pasty) discharge, pH more than 4.5, positive Whiff-test and the presence of clue cells. Results: The frequency of BV was observed to be 16.1% .The culture for Gardnerella vaginalis was compared with the composite clinical criteria. The sensitivity, specificity, positive and negative predictive values of the culture, calculated for the diagnosis of BV were 93.8%, 70%, 37.7% and 98% respectively. Conclusion: The use of laboratory tests in conjunction with clinical findings is necessary for diagnosis of BV. The composite clinical criteria for the diagnosis of BV are rapid, reliable and inexpensive method.

Cent Afr J Med. 2004 May-Jun;50(5-6):41-6.

Bacterial vaginosis and intravaginal practices: association with HIV.

Mbizvo ME, Musya SE, Stray-Pedersen B, Chirenje Z, Hussain A. Institute of General Practice and Community Medicine, Department of International Health, University of Oslo, Postboks 1130, Blindern 0317, Oslo.

OBJECTIVES: To determine the prevalence of bacterial vaginosis and to identify risk factors associated with this condition among urban women in Harare, Zimbabwe. DESIGN: A cross sectional study. MAIN OUTCOME MEASURES: Prevalent bacteria vaginosis (BV), HIV and intravaginal practices. SETTING: Urban primary health care clinics in Harare. SUBJECTS: 177 pregnant and 212 non pregnant women attending mother and child health care clinics. INTERVENTIONS: The women were recruited, counselled, interviewed, examined and tested for reproductive tract infections including HIV. Those with reproductive tract infections were given free treatment. RESULTS: The prevalence of bacterial vaginosis was 36% among HIV seropositive women and 26% among those seronegative. Fifty one per cent of the women practiced intravaginal cleansing, while another 28% reported use of intravaginal herbs. Women reporting intravaginal cleansing and/or use of intravaginal herbs were more likely to have bacterial vaginosis (OR 6.2 CI 3.6 to 10.7) and (OR 1.5 CI 1.1 to 2.5) and to be HIV seropositive (OR 1.8 CI 1.2 to 2.8) and (OR 1.8 CI 1.1 to 2.9) respectively. Other factors associated with bacterial vaginosis were malodorous vaginal discharge (OR 5.8 CI 2.9 to 10.7), genital warts (OR CI 3 CI 1.1 to 10.1) and Trichomonas vaginalis (OR 25.5 CI 11.6 to 56.7). CONCLUSIONS: BV was shown to be a common condition among the women the majority of whom indulged in intravaginal practices. HIV infection among women with BV and those that practiced intravaginal cleansing and/or use of herbs was significantly higher. Although causal relationship could not be established in this cross sectional study the results suggest that BV may facilitate HIV infection and we suggest the inclusion of information regarding risks associated with intravaginal practices into health education information disseminated to women.

J Infect Dis. 2005 Jun 1;191(11):1913-21. Epub 2005 Apr 28.

Induction of Tumor Necrosis Factor- alpha Secretion and Toll-Like Receptor 2 and 4 mRNA Expression by Genital Mucosal Fluids from Women with Bacterial Vaginosis.

Zariffard MR, Novak RM, Lurain N, Sha BE, Graham P, Spear GT. Department of Immunology and Microbiology, Rush University, Chicago, Illinois, USA.

Background. Bacterial vaginosis (BV) is associated with complications of pregnancy and increased susceptibility to human immunodeficiency virus (HIV) sexual transmission.Methods. The ability of genital mucosal fluids from women with BV and of microbial flora associated with BV to induce tumor necrosis factor (TNF)- alpha secretion and Toll-like receptor (TLR) 2 and TLR4 mRNA expression was assessed.Results. Primary peripheral-blood mononuclear cells and THP-1 monocytic cells secreted TNF- alpha in response to cervicovaginal lavage (CVL) samples from women with BV. Mycoplasma hominis and Gardnerella vaginalis also stimulated TNF- alpha secretion. Strikingly, CVL samples from women with BV induced up to 60-fold increases in TLR4 mRNA expression, compared with CVL samples from women without BV and with bacteria not associated with BV. Anti-TNF- alpha antibody blocked increases in TLR4 mRNA expression induced by CVL samples from women with BV, indicating that TNF- alpha plays a critical role in induction of TLR4. Both TLR2 and TLR4 mRNA expression were ~60-fold higher in cells isolated from the lumen of the genital tract than in cervical mucosal tissue, but lumen TLR mRNA levels did not change significantly after BV treatment.Conclusions. These experiments show that genital mucosal fluids and certain bacteria from women with BV stimulate TNF- alpha secretion and TLR4 mRNA expression, suggesting mechanisms whereby BV affects pregnancy and HIV transmission.

HPV Virus Research - Risk Associated with HPV and Vaginosis Links

Bacterial Vaginosis - Here you can read about risk factors associated with bacterial vaginosis.

Bacterial Vaginosis Information and Pictures - A very informative site on vaginosis and how to avoid getting it.