Correlation of Sexually Transmitted Infections and Bacterial Vaginosis Recurrence [ID 747]

INTRODUCTION: Bacterial vaginosis (BV) is a common vaginal dysbiosis with a bidirectional relationship to sexually transmitted infections (STIs) (chlamydia, gonorrhea, human papillomavirus [HPV], human immunodeficiency virus [HIV], and syphilis). Despite this relationship, few studies have linked BV recurrence to STI history. We evaluated the correlation between common STIs and BV recurrence. METHODS: We conducted a retrospective review of electronic medical records from the University of Illinois Hospital, between January 1, 2015, and September 9, 2023. Patients diagnosed with BV via gram stain were included and categorized as single BV and BV multiple (two or more positive tests in a year). Sexually transmitted infection history (chlamydia, gonorrhea, HPV, HIV, and syphilis) was assessed and categorized as positive ever, positive before BV, and positive after BV. RESULTS: A total of 6,217 positive BV patients were included: 4,882 single BV and 1,335 BV multiple. Bivariate analysis showed significant differences between single BV and BV multiple in positive ever chlamydia ( P =.009), positive ever gonorrhea ( P <.001), and gonorrhea positivity before BV rates ( P <.001). Positivity rates were higher in BV multiple than single BV for positive ever chlamydia (43% versus 23%), positive ever gonorrhea (37% versus 11%), and gonorrhea positivity before BV (34% versus 6.9%). In multivariate analysis, history of gonorrhea ( P <.001) and gonorrhea positivity before BV ( P <.001) were significantly associated with development of BV multiple relative to single BV yielding adjusted odds ratios of 4.04 for ever positive and 5.49 for positivity before BV. CONCLUSIONS/IMPLICATIONS: Our study demonstrates that chlamydia and gonorrhea infection are associated with BV recurrence. No results regarding HPV, HIV, or syphilis were statistically significant, possibly due to smaller sample sizes.