This week, groundbreaking research published in The New England Journal of Medicine has challenged the conventional understanding of bacterial vaginosis (BV), suggesting it is a sexually transmitted infection (STI). The study, conducted in Australia, involved 164 monogamous couples where the female partner was diagnosed with BV. Researchers randomly assigned couples to follow either traditional treatment or a new regimen that included treating the male partners with antibiotics and a topical antimicrobial cream.
The study found that treating both partners significantly reduced the recurrence rate of BV, marking a major shift in how this condition is understood. Traditionally, only women received antibiotic treatment for BV. However, the findings indicate that involving male partners in the treatment process is crucial. The recurrence rate was 65% among women whose partners were not treated, compared to 35% among those whose partners were.
"We’ve suspected for a long time that it’s a sexually transmitted infection (STI) because it has a similar incubation period (after sex) to most STIs and is associated with the same risk factors as STIs like chlamydia, such as change in sexual partner and not using condoms,” said Lenka Vodstrcil, PhD, deputy head of the Genital Microbiota and Mycoplasma Group at Monash University’s Melbourne Sexual Health Centre.
Bacterial vaginosis develops due to an imbalance in vaginal bacteria and can lead to symptoms such as itching, discharge, and a fishy smell. If left untreated, BV can increase the risk of contracting other STDs, including HIV, and can cause complications during pregnancy and birth. Notably, more than half of women experience a recurrence within three months after completing a weeklong course of oral antibiotics.
The research highlights that one-third of women globally will develop BV in their lifetime, with many facing recurring infections. These findings not only underscore the prevalence of BV but also emphasize the importance of comprehensive treatment strategies.
"Part of the difficulty in establishing whether BV is sexually transmitted has been that we still don’t know precisely which bacteria are the cause but advances in genomic sequencing are helping us close in on that mystery," explained Catriona Bradshaw, PhD, a fellow researcher involved in the study.
In an editorial accompanying the publication, infectious disease experts acknowledged this research as a significant paradigm shift. The evidence strongly supports that bacteria associated with BV are transmitted sexually, which contrasts with long-held views that BV was not an STI.
The implications of recognizing BV as an STI are profound. It suggests that health professionals may need to alter treatment protocols to include both partners, thereby potentially reducing the recurrence rates and associated health risks.
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