The Social Determinants of Health and Bacterial Vaginosis Reinfection in Chicago, Illinois [ID 1446]

INTRODUCTION: Bacterial vaginosis (BV) is one of the most common causes of vaginitis. Bacterial vaginosis, particularly, recurrent BV, is associated with sexually transmitted infections, pelvic inflammatory disease, and pregnancy complications. Our study explores the social determinants of BV among primarily minority women in a large health system in Chicago, Illinois. METHODS: We performed a retrospective review of electronic medical records of patients testing positive for BV at University of Illinois Health from January 2015 to September 2023. Patients were categorized as single positive, multiple positive (two or more positive BV results within 1 year), and recurrent BV (three or more positive BV results within 1 year). Multivariate logistic regression was used to detect individual-level effects whereas multivariate-mixed effects logistic regression was used to determine community-level effects. RESULTS: A total of 6,217 patients had positive BV results. Of these, 4,882 were single positive and 1,335 multiple positive; among multiple positive patients, 358 had recurrent BV. Patients with Medicaid and Medicare had increased rates of multiple positive BV ( P <.001). Preterm birth, poverty, hardship index, and homicide rates were significantly correlated with multiple positive BV but not recurrent BV. Decreased access to fruits and vegetables was associated with multiple ( P =.024) and recurrent BV ( P =.041). CONCLUSIONS/IMPLICATIONS: Access to fruit and vegetables was associated with lower rates of multiple and recurrent BV. No other factors were significant. Although the protective properties of fruits and vegetables are well-known, the exact mechanism is unknown. Further research to confirm the link will inform more effective management of multiple and recurrent BV.