San Francisco Chronicle (07.05.12)
Bacterial vaginosis (BV), a common condition marked by an overgrowth of abnormal flora in the vagina, could put women at increased risk for HIV, scientists are learning.
Previous research has shown that women with BV are 60 percent more likely to be HIV-infected than women with healthy vaginal flora, and they release more virus once infected.
A recent two-year study by investigators at the University of California-San Francisco (UCSF) looked at 2,236 couples in seven African countries, all in which the woman was HIV-positive and the man was HIV-negative. The women with BV were three times more likely to pass HIV to their partner than their counterparts with healthy flora.
Lead author Dr. Craig Cohen, a professor of obstetrics, gynecology and reproductive sciences at UCSF, noted that BV affects around 50 percent of women in some regions of the world and is especially common among black women in Africa and the United States. Symptoms of the condition include a thin discharge and unpleasant smell, but many women are asymptomatic. Many do not realize a problem because their vaginal flora have always been abnormal.
Treating the condition could significantly cut the spread of HIV. “It’s such a common condition that potentially a lot of HIV transmission can be related” to BV, Cohen said. “But we don’t have a good way of treating [BV] and normalizing the vaginal flora. That’s a really big problem.”
Cohen hopes the study will prompt further research into treating BV. The condition can be temporarily controlled with antibiotics, but recurrences are common. “People don’t consider [BV] a healthy, natural state. But if you have half the population of women with BV, it begs the question of what’s normal,” he noted.
[PNU editor’s note: The study, “Bacterial Vaginosis Associated with Increased Risk of Female-to-Male HIV-1 Transmission: A Prospective Cohort Analysis Among African Couples,” was published in PLoS Medicine (2012;doi:10.137/journal/pmed.1001251).]