(P473) Social and Behavioral Predictors of Recurrent Bacterial Vaginosis among Women Attending Sexual Health Clinics in New York City from 2014-2018

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Alissa Davis, PhD

Associate Professor
Columbia University School of Social Work
New York, New York, United States

Co-author(s)

AC

Addie Crawley
MA

Mary Ashmore
SL

Sara Landers
Preeti Pathela, DrPH, MPH (she/her/hers)

Executive Director - STI Programs
NYC Health Department
New York, New York, United States

Background: Bacterial vaginosis (BV) is associated with adverse reproductive outcomes and recurrence is common. We examined factors associated with BV recurrence using electronic medical record data for patients attending New York City Department of Health and Mental Hygiene sexual health clinics (SHCs) from 2014-2018.

Methods: Clinician-diagnosed BV was defined using a clinical BV diagnosis code based on Amsel criteria, including a positive whiff test and vaginal pH level greater than 4.5. Adjusted hazard ratios (AHRs) for the relationship between potential risk factors and recurrent BV were estimated using Prentice, Williams, and Peterson (PWP) conditional gap-time models.

Results: The dataset contained information on 14,858 patients with at least one BV diagnosis. Of these, 46.3% (n=6,882) had at least one follow-up visit to an SHC between January 2014 and December 2018. Of those with a follow-up visit, 53.9% (n=3,707) had ≥1 recurrent BV episode, with 33.7% (n=2,317) experiencing recurrence within 3 months. In the multivariable model, using a hormonal IUD (Adjusted Hazard Ratio (AHR): 1.24; 95% CI [1.10-1.39]) or copper IUD (AHR: 1.18; 95% CI [1.02-1.37]) and being non-Hispanic Black (AHR: 1.12; 95% CI [1.06-1.19]) were associated with higher risk for BV recurrence, while condom use (AHR: 0.95; 95% CI [0.90-1.00) and using non-IUD hormonal contraception were associated with reduced risk (AHR: 0.85; 95% CI [0.77-0.93]).

Conclusion: Risk of BV recurrence was increased among patients who were using an IUD, while it was reduced in patients using condoms or non-IUD hormonal contraception. Modifying behavioral practices may help increase the effectiveness of BV treatment.