1.  Title: Male condoms protect against bacterial vaginosis. Author: Family Health International [FHI] Source: [Research Triangle Park, North Carolina], FHI, [2009]. [1] p. (Research Briefs on the Male Condom) Abstract: Consistent condom use can reduce a woman's risk of acquiring bacterial vaginosis (BV), according to a study in Madagascar. Language: English Keywords: MADAGASCAR | SUMMARY REPORT | MULTIVARIATE ANALYSIS | SEX WORKERS | VAGINOSIS | PREVALENCE | RISK FACTORS | CONDOM USE | PREGNANCY COMPLICATIONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Analysis | Research Methodology | Sex Behavior | Behavior | Vaginal Abnormalities | Diseases | Measurement | Health | Risk Reduction Behavior Document Number: 331749 |
2.  Title: Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. Author: Ahmad A; Khan AU Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009 May;144(1):68-71. Abstract: OBJECTIVES: The objectives were to determine the frequency of Candida species in women of different age groups as well as to suggest the criteria for the diagnosis of vulvovaginal candidiasis (VVC). STUDY DESIGN: A prospective study of vulvovaginal candidiasis was carried out using laboratory diagnosis, with the estimation of vaginal pH and the direct microscopic and biochemical examination of vaginal discharge/secretions. Vaginal cultures for Candida species were collected from 1050 women with vulvovaginal symptoms. RESULTS: Out of 1050 women, 215 (20.47%) were positive for Candida species. Of 215 women, 172 (80%) had pH within the normal range and 167 (77.67%) were showing yeast cells and mycelia on direct microscopic examination. Candida albicans accounted for 46.9% of cases, Candida glabrata 36.7%, Candida parapsilosis 10.2%, Candida tropicalis 2.8%, Candida krusei 1.4%, and Candida kiefer 1.9%. The frequency of culture positivity was related to pregnancy (P<0.001), an increase in parity (P<0.001), and use of oral contraceptives (P<0.001) and antibiotics (P<0.001). The most common signs and symptoms in 215 women with positive cultures were pruritus with or without vaginal discharge and vaginal erythema. CONCLUSION: Our study suggests that vulvovaginal candidiasis can only be diagnosed by using clinical criteria in correlation with vulvovaginal symptoms and Candida cultures. Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CANDIDIASIS | RISK FACTORS | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | PRURITUS | VAGINITIS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Bacterial and Fungal Diseases | Infections | Diseases | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Dermatitis | Vaginal Abnormalities Document Number: 342002 |
| 3. Title: Perspectives on sexual and reproductive health among women in an ancient mining area in Brazil. Author: Miranda AE; Mercon-de-Vargas PR; Corbett CE; Corbett JF; Reynaldo D Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2009 Feb;25(2):157-161. Abstract: The purpose of this study was to describe the reproductive profile and frequency of genital in fections among women living in the Serra Pelada, a former mining village in the Pará state, Brazil. A descriptive study of women living in the mining area of Serra Pelada was performed in 2004 through interviews that gathered demographics and clinical data, and assessed risk be haviors of 209 randomly-selected women. Blood samples were collected for rapid assay for HIV; specimens were taken for Pap smears and Gram stains. Standard descriptive statistical analy ses were performed and prevalence was calculated to reflect the relative frequency of each dis ease. Of the 209 participants, the median age was 38 years, with almost 70% having less than four years of education and 77% having no income or under 1.9 times the minimum wage of Brazil. About 30% did not have access to health care services during the preceding year. Risk behaviors included: alcohol abuse, 24.4%; illicit drug abuse, 4.3%; being a sex worker, 15.8%; and domestic violence, 17.7%. Abnormal Pap smear was found in 8.6%. Prevalence rates of in fection were: HIV, 1.9%; trichomoniasis, 2.9%; bacterial vaginosis, 18.7%; candidiasis, 5.7%; Chlamydial-related cytological changes, 3.3%; and HPV-related cytological changes, 3.8%. Women living in this mining area in Brazil are economically and socially vulnerable to health problems. It is important to point out the importance of concomitant broader strategies that include reducing poverty and empowering women to make improvements regarding their health. Language: English Keywords: BRAZIL | RESEARCH REPORT | WOMEN | MINE WORKERS | REPRODUCTIVE HEALTH | HEALTH SERVICES | PROGRAM ACCESSIBILITY | PAP SMEAR | RISK BEHAVIOR | CANDIDIASIS | VAGINOSIS | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | PREVALENCE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Labor Force | Human Resources | Economic Factors | Health | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Behavior | Bacterial and Fungal Diseases | Infections | Diseases | Vaginal Abnormalities | Reproductive Tract Infections | Viral Diseases | Measurement | Research Methodology Document Number: 341876 |
| 4. Peer Reviewed Title: Do users of the intrauterine system (Mirena) have different genital symptoms and vaginal flora than users of the intrauterine contraceptive device? Author: Neale R; Knight I; Keane F Source: International Journal of STD and AIDS. 2009 Jun;20(6):423-4. Abstract: The copper intrauterine contraceptive device (IUCD) is strongly associated with bacterial vaginosis (BV). Hormonal influences may play a role in the control of vaginal flora. It is unclear whether use of the progesterone-incorporated intrauterine system (IUS; Mirena) is associated with abnormal vaginal flora or genital symptoms. One hundred and seventy-two women were assessed for symptoms and abnormal vaginal flora prior to and at intervals after insertion of either a copper IUCD or an IUS. Women were significantly more likely to have developed an abnormal vaginal discharge 4-6 weeks after insertion of an IUCD compared with an IUS (27% cf. 14%, P = 0.04), although this trend was not significant six months postinsertion. More women with an IUCD developed BV compared with an IUS at 4-6 weeks and six months. However, there were insufficient numbers of women with BV to demonstrate any significant difference between the vaginal flora of the two groups. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | IUD, COPPER RELEASING | VAGINOSIS | SIGNS AND SYMPTOMS | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | IUD | Contraceptive Methods | Contraception | Family Planning | Vaginal Abnormalities | Diseases Document Number: 341197 |
| 5. Peer Reviewed Title: Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD. Author: Rifkin SB; Smith MR; Brotman RM; Gindi RM; Erbelding EJ Source: Contraception. 2009 Jul;80(1):63-7. Abstract: BACKGROUND: The protective effect of hormonal contraception may offer a potential intervention against bacterial vaginosis (BV). STUDY DESIGN: Three hundred thirty reproductive-age women enrolled in a contraceptive program from April 2005 to October 2006 at two sexually transmitted diseases clinics in Baltimore, MD. Participants were supplied with hormonal contraceptives of their choice and followed prospectively. BV was diagnosed by Amsel's criteria. Results from population-level analysis were compared to a case-crossover analysis. RESULTS: BV was diagnosed in 189 (13.0%) of the visits among 133 (40.3%) women. In the population-level analysis, the use of progestin-only and combined contraception was associated with a decreased risk of BV compared to intervals of no hormonal contraceptive use [adjusted odds ratio (AOR): 0.42 (95% CI: 0.20-0.88) and AOR: 0.66 (95% CI: 0.39-1.10), respectively]. The case-crossover analysis demonstrated a similar trend in findings. CONCLUSION: Hormonal contraception was associated with a decreased risk of BV in an STD clinic cohort. Language: English Keywords: UNITED STATES OF AMERICA | MARYLAND | RESEARCH REPORT | DATA ANALYSIS | CLINIC ACTIVITIES | WOMEN | VAGINOSIS | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | Developed Countries | North America | Americas | Research Methodology | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Medroxyprogesterone Acetate | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods Document Number: 341582 |
| 6. Title: Sexually transmitted infections and reproductive tract infections in female sex workers. Author: Shethwala ND; Mulla SA; Kosambiya JK; Desai VK Source: Indian Journal of Pathology and Microbiology. 2009 Apr-Jun;52(2):198-9. Abstract: The present study was conducted in 300 female sex workers (FSWs) from Surat city in 2005-2006. Vaginal swabs, endocervical swabs and serum samples were collected from each of these FSWs. Vaginal samples were screened for bacterial vaginosis (BV), candidiasis and Trichomonas vaginalis . Endocervical swabs were screened for gonococcal infection. Serological tests for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and syphilis were performed. From a total of 300 FSWs, BV was detected in 40 (13.33%), trichomoniasis in six (2%), candidiasis in 31 (10.33%), HIV seropositivity in 35 (11.66%), HBsAg reactivity in 10 (3.33%) and rapid plasma regain (RPR) reactivity in 20 (6.66%) cases. RPR-positive serum samples were confirmed by the treponema pallidum hemaglutination test. Gonococcal infection was not found in any of the FSWs. Of the total of 35 HIV-positive patients, 20 patients had associated coinfection. Of the 35 HIV-seropositive FSWs, BV was detected in six (17.14%), candidiasis in six (17.14%), syphilis in five (14.28%) and HBsAg in two (5.71%). One (2.85%) HIV-positive FSW was positive for both candidiasis and syphilis. Language: English Keywords: INDIA | RESEARCH REPORT | WOMEN | SEX WORKERS | PERSONS LIVING WITH HIV/AIDS | SCREENING | VAGINOSIS | CANDIDIASIS | SYPHILIS | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | REPRODUCTIVE TRACT INFECTIONS | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Sex Behavior | Behavior | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Abnormalities | Bacterial and Fungal Diseases | Infections Document Number: 341349 |
| 7. Peer Reviewed Title: Some minor female reproductive system disorders: findings in the Oxford-Family Planning Association contraceptive study. Author: Vessey M; Yeates D Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):105-10. Abstract: BACKGROUND: The Oxford-Family Planning Association (Oxford-FPA) contraceptive study has provided information on many serious diseases of the female reproductive tract. No information has been published about a number of common minor conditions. This report fills the gap with regard to uterine polyp, cervicitis, cervical erosion, and vaginitis and vulvitis. METHODS: The Oxford-FPA study includes 17 032 married women recruited at ages 25-39 years between 1968 and 1974 from clinics in England and Scotland. These women were followed up until mid-1994. Information collected during follow-up included details of contraceptive use, cervical smears taken at the clinic, pregnancies and hospital referrals. RESULTS: Oral contraceptive (OC) use was associated with a reduction in first hospital referral for uterine polyp and for vaginitis and vulvitis, which became more marked with increasing duration of use. There was a slightly increased rate of hospital referral for cervicitis in OC users. Referral for cervical erosion was markedly increased in current and recent OC users (rate ratio 2.1, 95% confidence interval 1.8-2.4). This increase in risk steadily declined after OC use was discontinued. First hospital referral for both uterine polyp and cervical erosion showed a highly significant negative association with numbers of cigarettes smoked per day. The explanation for these observations is unknown. CONCLUSIONS: It should be remembered that the OCs studied were mainly those used in the 1970s and 1980s and mostly contained 50 mug estrogen. On balance, the overall effect of OC use on the conditions considered was neutral or beneficial. The apparent protective effect of cigarette smoking against uterine polyp and cervical erosion, even if valid, counts as nothing against the overwhelming adverse effects of smoking on health. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | LONGITUDINAL STUDIES | WOMEN | CURRENTLY MARRIED | PREVALENCE | VAGINITIS | UTERUS | DISEASES | CERVICAL EFFECTS | REPRODUCTIVE TRACT INFECTIONS | CONTRACEPTIVE USAGE | PAP SMEAR | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Marital Status | Nuptiality | Measurement | Vaginal Abnormalities | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Cervix | Infections | Contraception | Family Planning | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330947 |
| 8. Peer Reviewed Title: Effect of consistent condom use on 6-month prevalence of bacterial vaginosis varies by baseline BV status. Author: Yotebieng M; Turner AN; Hoke TH; Van Damme K; Rasolofomanana JR; Behets F Source: Tropical Medicine and International Health. 2009 Apr;14(4):480-6. Abstract: OBJECTIVES: Bacterial vaginosis (BV) is a condition characterized by a disturbed vaginal ecosystem which fluctuates in response to extrinsic and intrinsic factors. BV recurrence is common. To explore whether consistent condom use was associated with BV occurrence or recurrence, we compared the effect of condom use on BV prevalence after 6 months, among women with and without BV at baseline. METHODS: We used data from a randomized controlled trial, conducted among female sex workers in Madagascar during 2000-2001, that assessed the impact of adding clinic-based counselling to peer education on sexual risk behaviour and sexually transmitted infection incidence. BV was diagnosed at two time points (baseline and 6 months) according to modified Amsel criteria. Consistent condom users were women reporting no unprotected sex acts with clients in the past month or non-paying partners in the past year. Adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using multivariable regression models. RESULTS: At baseline, 563 (56%) women had BV. Of those, 360 (72%) had BV at 6 months, compared to 158 (39%) without BV at baseline. The adjusted 6-month PR for BV comparing consistent to inconsistent condom users was 0.99 (95% CI: 0.85-1.13) among women with BV at baseline and 0.57 (95% CI: 0.30-0.94) among women without BV at baseline. CONCLUSIONS: Consistent condom use was associated with reduced BV prevalence at 6 months for women who were BV-negative at baseline, but had no effect among women who were BV-positive at baseline. Male condoms appeared to protect against BV occurrence, but not BV recurrence. Language: English Keywords: MADAGASCAR | RESEARCH REPORT | SEX WORKERS | CONDOM USE | VAGINOSIS | PREVALENCE | SEX BEHAVIOR | COUNSELING | DRUGS | ADMINISTRATION AND DOSAGE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Behavior | Risk Reduction Behavior | Vaginal Abnormalities | Diseases | Measurement | Research Methodology | Clinic Activities | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341695 |
| 9. Peer Reviewed Title: Bacterial vaginosis and HIV acquisition: A meta-analysis of published studies. Author: Atashili J; Poole C; Ndumbe PM; Adimora AA; Smith JS Source: AIDS. 2008 Jul;22(12):1493-1501. Abstract: The objective of this study was to assess and summarize the published literature on the extent to which bacterial vaginosis may increase the risk of HIV acquisition. The design of the study was a meta-analysis of published studies. Medline and other electronic databases were systematically searched for eligible publications. The association between bacterial vaginosis and incident HIV was separately analyzed from that between bacterial vaginosis and prevalent HIV. The latter was further analyzed, stratified by bacterial vaginosis diagnostic method, HIV risk profile of the study population, and whether or not adjusted estimates were presented. Twenty-three eligible publications were identified, including a total of 30,739 women. Bacterial vaginosis was associated with an increased risk of HIV acquisition in HIV-incidence studies (relative risk=1.6, 95% confidence interval: 1.2, 2.1). All but one of 21 HIV-prevalence studies reported estimates above the null. The latter results were heterogeneous and showed some evidence of funnel plot asymmetry, precluding the estimation of a single summary measure. The association between bacterial vaginosis and HIV in prevalence studies appeared stronger for women without high-risk sexual behavior. Bacterial vaginosis was consistently associated with an increased risk of HIV infection. High bacterial vaginosis prevalence may result in a high number of HIV infections being attributable to bacterial vaginosis. More prospective studies are needed to accurately evaluate the role of bacterial vaginosis in HIV acquisition in low-risk versus high-risk women. Furthermore, randomized clinical trials may be worth considering to determine the effect of bacterial vaginosis control measures on HIV acquisition. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | VAGINOSIS | HIV INFECTIONS | HIV TRANSMISSION | RISK FACTORS | Vaginal Abnormalities | Diseases | Viral Diseases | Biology Document Number: 327660 |
| 10. Peer Reviewed Title: Probiotics: Potential to prevent HIV and sexually transmitted infections in women. Author: Bolton M; Van der Straten A; Cohen CR Source: Sexually Transmitted Diseases. 2008 Mar;35(3):214-225. Abstract: Women are at significant risk of human immunodeficiency virus (HIV) and sexually transmitted infection (STI) acquisition with the genital mucosa serving as the main portal of infection. Exogenously supplied lactobacillus used as a probiotic may prove a cost-effective, female-initiated method to prevent HIV and STI infection in women. A probiotic may act indirectly through treating and preventing recurrent bacterial vaginosis or directly by secreting endogenous (e.g., hydrogen peroxide) and exogenous substances that block HIV and STI transmission. This review summarizes the preclinical and clinical studies that have been conducted so far to test probiotic bacteria for these purposes. Although significant progress has been made in this field, more fundamental research is required to better understand vaginal ecology to maximize probiotic formulations. Once identified, a suitable product will require testing in a well-designed, randomized, placebo-controlled trial to measure its effectiveness in augmenting antibiotic treatment to prevent bacterial vaginosis. If results from such a trial demonstrate efficacy, future studies should be designed to determine whether a probiotic can significantly lower the risk for HIV and STIs in at-risk female populations. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | WOMEN | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | VAGINA | GENITAL EFFECTS, FEMALE | VAGINOSIS | Developed Countries | North America | Americas | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Vaginal Abnormalities Document Number: 324209 |
| 11. Title: A universal combination treatment for vaginitis. Author: Bornstein J; Zarfati D Source: Gynecologic and Obstetric Investigation. 2008 Apr;65(3):195-200. Abstract: We compared a novel vaginal tablet consisting of 100 mg of clotrimazole and 100 mg of metronidazole ('Clo-Met') to a 100-mg clotrimazole tablet in the treatment of vaginitis. The method used was a multicenter, double-blind, randomized controlled study. Women with vaginal discharge and diagnosed as suffering from vaginitis caused by Trichomonas vaginalis, bacterial vaginosis or Candida albicans, or any combination of the three, and who had not received treatment for vaginitis during the previous month, were studied. 165 patients were enrolled into the study - 84 into the combined therapy group, and 81 into the clotrimazole group. In women with Candida vaginitis, Clo-Met was more effective than clotrimazole treatment (p less than 0.012 and p less than 0.05, respectively). A combination vaginal tablet consisting of clotrimazole and metronidazole is therapeutically effective in candidal vaginitis. The effectiveness of Clo-Met on bacterial vaginosis, T. vaginalis infection as well as on vaginal infections due to a combination of these microorganisms should be studied further. (author's) Language: English Keywords: ISRAEL | RESEARCH REPORT | DOUBLE-BLIND STUDIES | WOMEN | EXAMINATIONS AND DIAGNOSES | VAGINITIS | VAGINAL TABLET | DRUGS | ADMINISTRATION AND DOSAGE | SIDE EFFECTS | CONTRACEPTIVE USE-EFFECTIVENESS | Developed Countries | Middle East | Studies | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Abnormalities | Diseases | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Treatment | Contraceptive Effectiveness Document Number: 326918 |
| 12. Title: Gynecologic issues in the HIV-infected woman. Author: Cejtin HE Source: Infectious Disease Clinics of North America. 2008 Dec;22(4):709-39, vii. Abstract: In this article, gynecologic conditions of increased importance in the HIV-infected woman are discussed. Women living with HIV may have an increase in menstrual disorders, lower genital tract neoplasias, gynecologic surgery, and sexually transmitted infections. The literature relevant to choosing a method of contraception for HIV-positive women is also discussed. With the advent of HAART, seropositive women are now facing issues around longevity, such as menopause and disorders of bone mineral density, as well as those associated with fertility. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | MANAGEMENT | WOMEN | VAGINITIS | PELVIC INFECTIONS | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Organization and Administration | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Infections | Reproductive Tract Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329614 |
| 13. Peer Reviewed Title: The effect of genital tract infections on HIV-1 shedding in the genital tract: a systematic review and meta-analysis. Author: Johnson LF; Lewis DA Source: Sexually Transmitted Diseases. 2008 Nov;35(11):946-59. Abstract: This article reviews the effect of genital tract infections and associated clinical conditions on the detection and concentration of HIV-1 shedding in the genital tract. A search of the PubMed, Embase, and AIDSearch databases was conducted. Meta-analysis was performed on those studies that reported the effect of genital tract infections on the detection of HIV-1 shedding. Thirty-nine studies met the inclusion criteria. The odds of HIV-1 detection in the genital tract were increased most substantially by urethritis (OR 3.1, 95% CI: 1.1-8.6) and cervicitis (OR 2.7, 95% CI: 1.4-5.2). The odds of HIV-1 detection were also increased significantly in the presence of cervical discharge or mucopus (OR 1.8, 95% CI: 1.2-2.7), gonorrhoea (OR 1.8, 95% CI: 1.2-2.7), chlamydial infection (OR 1.8, 95% CI: 1.1-3.1), and vulvovaginal candidiasis (OR 1.8, 95% CI: 1.3-2.4). Other infections and clinical conditions were found to have no significant effect on the detection of HIV-1, although HSV-2 shedding was found to increase the concentration of HIV-1 shedding, and genital ulcer disease was found to increase the odds of HIV-1 detection significantly after excluding one biased study (OR 2.4, 95% CI: 1.2-4.9). This analysis shows that infections that are associated with significant increases in leukocyte concentrations in the genital tract are also associated with significant increases in HIV-1 shedding. These infections are likely to be particularly important in promoting the sexual transmission and mother-to-child intrapartum transmission of HIV-1, and should therefore be the focus of HIV prevention strategies. Language: English Keywords: GLOBAL | RESEARCH REPORT | DATA ANALYSIS | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | GENITAL EFFECTS, FEMALE | GENITAL EFFECTS, MALE | CANDIDIASIS | VAGINOSIS | TRICHOMONIASIS | HIV TRANSMISSION | Research Methodology | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Genitalia, Male | Bacterial and Fungal Diseases | Vaginal Abnormalities Document Number: 341443 |
| 14. Peer Reviewed Title: The polymicrobial hypothesis of bacterial vaginosis causation: A reassessment. Author: Josey WE; Schwebke JR Source: International Journal of STD and AIDS. 2008 Mar;19(3):152-154. Abstract: The cause of bacterial vaginosis remains controversial. The two leading hypotheses are that Gardnerella vaginalis is the specific aetiologic agent versus the polymicrobial hypothesis that G. vaginalis acts in concert with other bacteria, principally anaerobes, to produce the disease. Here we reassess the prevailing polymicrobial hypothesis, finding it conceptually problematical. No host initiating factors as postulated have been identified, nor is there conclusive evidence that G. vaginalis lacks diagnostic specificity for the disease. The polymicrobial hypothesis, presupposing a unique disruption of vaginal microecology, is inconsistent with the epidemiological profile of the syndrome, which is that of a sexually transmitted disease. The epidemiological and clinical similarities between bacterial vaginosis and trichomoniasis suggest a similar pathogenetic process; i.e., primary causation by a specific agent, with secondary anaerobic activation and resultant amine production. (author's) Language: English Keywords: GLOBAL | LITERATURE REVIEW | WOMEN | VAGINOSIS | BACTERIAL AND FUNGAL DISEASES | SIGNS AND SYMPTOMS | EPIDEMIOLOGY | TRICHOMONIASIS | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Infections | Public Health | Health | Sexually Transmitted Diseases | Reproductive Tract Infections Document Number: 325956 |
| 15. Peer Reviewed Title: Zataria multiflora cream for the treatment of acute vaginal candidiasis. Author: Khosravi AR; Eslami AR; Shokri H; Kashanian M Source: International Journal of Gynecology and Obstetrics. 2008 May;101(2):201-202. Abstract: Vaginitis is the most prevalent gynecologic problem and the reason for 10 million consultations per year. Topical drugs, including imidazoles and triazoles, are used for the treatment of vaginal candidiasis. In some cases, however, these drugs are ineffective or produce adverse effects, or they are associated with a high rate of relapse. Carvacrol, thymol, and eugenol are the antimicrobial components of Zataria multiflora oil and Fataneh and Mahmoudabadi et al. have demonstrated their anti-Candida activity in 2 in-vitro studies. The purpose of the present study was to evaluate the efficacy of a 0.1% vaginal cream prepared with the essential oil of Z. multiflora in treating acute vaginal candidiasis. (excerpt) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | VAGINITIS | PREVALENCE | CANDIDIASIS | DRUGS | ADMINISTRATION AND DOSAGE | TREATMENT | SIGNS AND SYMPTOMS | Developing Countries | Middle East | Clinical Research | Research Methodology | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Measurement | Bacterial and Fungal Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325982 |
| 16. Peer Reviewed Title: Female genital schistosomiasis--a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe. Author: Kjetland EF; Kurewa EN; Ndhlovu PD; Midzi N; Gwanzura L; Mason PR; Gomo E; Sandvik L; Mduluza T; Friis H; Gundersen SG Source: Tropical Medicine and International Health. 2008 Dec;13(12):1509-17. Abstract: OBJECTIVE: To examine the association between schistosomiasis and reproductive tract symptoms. METHOD: A cross-sectional study was conducted in a Schistosoma haematobium-endemic area of rural Zimbabwe. A total of 483 permanently resident adult women of Mupfure Ward aged 20-49 were interviewed and examined clinically, each providing three consecutive urine samples. Logistic regression analysis was used to control for sexually transmitted diseases (STDs). RESULTS: Women with genital sandy patches had significantly more genital itch (P = 0.009) and perceived their discharge as abnormal (P = 0.003). Eighty percent of the women who had genital itch, yellow discharge, and childhood or current waterbody contact had sandy patches. Fifty-two percent of the women with genital sandy patches did not have detectable S. haematobium ova in urine. Genital schistosomiasis was associated with stress incontinence and pollakisuria, but not with menstrual irregularities, current or previous ulcers, or tumours. CONCLUSION: Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas. Because of the chronic nature of the disease in adults, we suggest to pay special attention to the prevention of morbidity. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | STATISTICAL REGRESSION | WOMEN IN DEVELOPMENT | RURAL POPULATION | SCHISTOSOMIASIS | SEXUALLY TRANSMITTED DISEASES | VAGINAL DESQUAMATE EFFECTS | SIGNS AND SYMPTOMS | MENSTRUATION DISORDERS | PHYSICAL EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Reproductive Tract Infections | Infections | Vaginitis | Vaginal Abnormalities | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330045 |
| 17. Peer Reviewed Title: Natural history and risk factors associated with early and established HIV type 1 infection among reproductive-age women in Malawi. Author: Kumwenda JJ; Makanani B; Taulo F; Nkhoma N; Kafulafula G Source: Clinical Infectious Diseases. 2008 Jun;46(12):1913-1920. Abstract: Data evaluating the biological events and determinants of early human immunodeficiency virus type 1 (HIV-1) infection are limited in sub-Saharan Africa. We examined plasma viral levels and trends during early and established HIV-1 infection among reproductive-age women who participated in a randomized trial to treat genital tract infection in Malawi. We also assessed the association of injectable hormonal contraceptive use with HIV-1 infection. We studied 3 groups of women who were infected or uninfected with HIV-1: seroconverters, seroprevalent women, and seronegative women. Questionnaires and blood samples were collected at baseline and every 3 months for 1 year. The virus set point in seroconverters and levels and trends of viral load over time were determined. The associations of injectable hormonal contraceptive use with HIV-1 infection and viral load were assessed using conditional logistic regression and mixed-effect models, respectively. In the original clinical trial, 844 women infected with HIV-1 and 842 women not infected with HIV- 1 were enrolled. Of 31 women who experienced seroconversion during 12 months, 27 were matched with 54 seroprevalent and 54 seronegative women. The estimated median plasma virus set point was 4.45 log10 copies/mL (interquartile range, 4.32-5.14 log10 copies/mL). Injectable hormonal contraceptive use was significantly associated with HIV-1 seroconversion (adjusted odds ratio, 10.42; Pp.03) but not with established HIV-1 infection. Among the seroconverters, a statistically significant interaction was found between the linear association of viral load and time of injectable hormonal contraceptive use (regression coefficient, _0.14; Pp.02). Knowledge of virus set point and trends of viral load in HIV-1 seroincident and seroprevalent asymptomatic women could assist in antiretroviral treatment management. (author's) Language: English Keywords: MALAWI | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | HIV INFECTIONS | INJECTABLES | VAGINOSIS | SEXUAL PARTNERS | EPIDEMIOLOGY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Demographic Factors | Population | Viral Diseases | Diseases | Contraceptive Methods | Contraception | Family Planning | Vaginal Abnormalities | Sex Behavior | Behavior | Public Health | Health Document Number: 326898 |
| 18. Peer Reviewed Title: HIV-1 incidence among women of reproductive age in Malawi. Author: Kumwenda NI; Kumwenda J; Kafulafula G; Makanani B; Taulo F Source: International Journal of STD and AIDS. 2008 May;19(5):339-341. Abstract: The aim of this study was to determine HIV-1 incidence among women of reproductive age in Malawi. A prospective study design was followed. HIV-1 uninfected women were followed up for nine visits during a period of 12 months. At baseline, women received HIV-1 counselling and testing. At each visit, venous blood was collected for HIV-1 testing. Incidence rate for HIV-1 was estimated using person-years of follow up (PYFU). Risk factors for HIV acquisition were assessed using Cox proportional hazard models. A total of 842 HIV-1 negative women were enrolled in the study. Of these, 787 had subsequent HIV testing and 31 were found HIV-1 infected; an overall incidence rate of 4.51 (95% confidence interval: 2.96-6.06) per 100 PYFU was obtained. Young age, using hormonal injectable contraceptives and bacterial vaginosis were the main predictors of HIV acquisition. The incidence of HIV continues to be high among women in Malawi, and young women appear to be at higher risk. Language: English Keywords: MALAWI | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PROSPECTIVE STUDIES | THEORETICAL MODELS | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | PREVALENCE | HIV INFECTIONS | AGE FACTORS | RISK FACTORS | RISK BEHAVIOR | INJECTABLES | VAGINOSIS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Economic Development | Economic Factors | Measurement | Population Characteristics | Demographic Factors | Population | Biology | Behavior | Contraceptive Methods | Contraception | Family Planning | Vaginal Abnormalities Document Number: 327732 |
| 19. Title: A model of the differentiation and relative incidence of glandular versus squamous cell neoplasia of the uterine cervix: connection between incidence and etiology. Author: Leppaluoto PA Source: Acta Obstetricia et Gynecologica Scandinavica. 2008;87(8):800-3. Abstract: It has remained unclear why cervical adenocarcinoma, as observed in consecutive screening, has rapidly increased during the past decades, while at the same time both that of squamous cell carcinoma (SCC) and the combined toll of adeno- and SCC have consistently decreased. Here it is argued that this might be ascribed to coitus-related changes in the cervicovaginal milieu, where the target cells become infected through a coital act. Frequent alterations in vaginal acidity and changing sexual habits in the era after the oral contraceptive pills and even after the introduction of erectile dysfunction medication, contribute to the pathogenetic scene. Language: English Keywords: FINLAND | RESEARCH REPORT | INCIDENCE | SEXUAL INTERCOURSE | GENITAL EFFECTS, MALE | NEOPLASMS | CERVICAL EFFECTS | HPV | CONTRACEPTIVE USAGE | VAGINOSIS | Europe, Northern | Europe | Developed Countries | Measurement | Research Methodology | Reproduction | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Diseases | Cervix | Uterus | Genitalia, Female | Viral Diseases | Contraception | Family Planning | Vaginal Abnormalities Document Number: 328662 |
| 20. Title: Prevalence and correlates of bacterial vaginosis among young women of reproductive age in Mysore, India. Author: Madhivanan P; Krupp K; Chandrasekaran V; Karat C; Arun A Source: Indian Journal of Medical Microbiology. 2008;26(2):132-137. Abstract: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age and is associated with STI/HIV and adverse birth outcomes. The objective of this study was to determine the prevalence and correlates of BV among young women of reproductive age in Mysore, India. Between October 2005 and December 2006, 898 sexually active women of 15-30 years of age were enrolled from two reproductive health clinics in Mysore. The women underwent an interview followed by physical examination, HSV-2 serologic testing, endocervical culture for Neissera gonorrhoeae, and vaginal swabs for diagnosis of BV, Trichomonas vaginalis infection and candidiasis. Statistical analyses included conventional descriptive statistics and multivariable analysis using logistic regression. Of the 898 women, 391 (43.5%) were diagnosed with greater than or equal to 1 endogenous reproductive tract infection and 157 (17.4%) with greater than or equal to 1 sexually transmitted infection. Only 863 women had Gram-stained vaginal smears available, out of which 165 (19.1, 95% confidence interval [CI]: 16.3%-22.2%) were found to have BV and 133 (15.4, 95% CI: 12.9%-18.3%) were in the 'intermediate' stage. BV was related to concurrent infections with T. vaginalis (odds ratio [OR] = 4.07, 95% CI: 2.45-6.72) and HSV-2 seropositivity (OR = 2.22, 95% CI: 1.39-3.53). In this population, the prevalence of BV at 19% was relatively low. Coinfection with T. vaginalis, however, was common. BV was independently associated with concurrent T. vaginalis infection and partner's alcohol use. Muslim women had reduced odds BV as compared to non-Muslim women. Further research is needed to understand the role of T. vaginalis infection in the pathogenesis of BV and the sociocultural context surrounding the condition in India. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | CORRELATION STUDIES | WOMEN | VAGINOSIS | PREVALENCE | SEXUALLY TRANSMITTED DISEASES | EPIDEMIOLOGY | RISK FACTORS | Developing Countries | Asia, Southern | Asia | Research Methodology | Statistical Studies | Studies | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Measurement | Reproductive Tract Infections | Infections | Public Health | Health | Biology Document Number: 326377 |
| 21. Peer Reviewed Title: A prospective study of risk factors for bacterial vaginosis in HIV-1-seronegative African women. Author: McClelland RS; Richardson BA; Graham SM; Masese LN; Gitau R Source: Sexually Transmitted Diseases. 2008 Jun;35(6):617-623. Abstract: Bacterial vaginosis (BV) is common and has been associated with increased HIV-1 susceptibility. The objective of this study was to identify risk factors for BV in African women at high risk for acquiring HIV-1. We conducted a prospective study among 151 HIV-1-seronegative Kenyan female sex workers. Nonpregnant women were eligible if they did not have symptoms of abnormal vaginal itching or discharge at the time of enrollment. At monthly follow-up, a vaginal examination and laboratory testing for genital tract infections were performed. Multivariate Andersen-Gill proportional hazards analysis was used to identify correlates of BV. Participants completed a median of 378 (interquartile range 350-412) days of follow-up. Compared with women reporting no vaginal washing, those who reported vaginal washing 1 to 14 [adjusted hazard ratio (aHR) 1.29, 95% confidence interval (CI) 0.88-1.89], 15 to 28 (aHR 1.60, 95% CI 0.98 -2.61), and greater than 28 times/wk (aHR 2.39, 95% CI 1.35-4.23) were at increased risk of BV. Higher BV incidence was also associated with the use of cloth for intravaginal cleansing (aHR 1.48, 95% CI 1.06 -2.08) and with recent unprotected intercourse (aHR 1.75, 95% CI 1.47-2.08). Women using depot medroxyprogesterone acetate contraception were at lower risk for BV (aHR 0.59, 95% CI 0.48-0.73). Vaginal washing and unprotected intercourse were associated with increased risk of BV. These findings could help to inform the development of novel vaginal health approaches for HIV-1 risk reduction in women. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | PROSPECTIVE STUDIES | SEX WORKERS | VAGINOSIS | RISK FACTORS | LABORATORY EXAMINATIONS AND DIAGNOSES | SEX BEHAVIOR | HYGIENE | DEPO-PROVERA | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Vaginal Abnormalities | Diseases | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning Document Number: 327423 |
| 22. Title: The association of bacterial vaginosis and preterm labor. Author: Nejad VM; Shafaie S Source: JPMA. Journal of the Pakistan Medical Association. 2008 Mar;58(3):104-106. Abstract: The objective was to determine the relationship between bacterial vaginosis and preterm labour. In this study 160 labouring women admitted in Bahonar Hospital were studied for the presence of bacterial vaginosis based on the presence of clue cells. Control group consisted of 80 women with the gestational age of more than 38 weeks and the case group consisted of 80 women with the gestational age of 20-37 weeks. The two groups were compared in regard to the presence of bacterial vaginosis. In the study group 25% of subjects with preterm labour had bacterial vaginosis, while in the control group only 11.3% had symptoms of bacterial vaginosis that shows a significant difference (P = 0.039). Bacterial vaginosis can induce preterm labor. Therefore the screening of high-risk women for bacterial vaginosis is highly recommended. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | VAGINOSIS | PREMATURE LABOR | RISK FACTORS | Developing Countries | Middle East | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Biology Document Number: 325024 |
| 23. Peer Reviewed Title: Male reproductive proteins and reproductive outcomes. Author: Ness RB; Grainger DA Source: American Journal of Obstetrics and Gynecology. 2008 Jun;198(6):620.e1-620.e4. Abstract: Male reproductive proteins (MRPs), associated with sperm and semen, are the moieties responsible for carrying male genes into the next generation. Evolutionary biologists have focused on their capacity to control conception. Immunologists have shown that MRPs cause female genital tract inflammation as preparatory for embryo implantation and placentation. These observations argue that MRPs are critically important to reproductive success. Yet the impact of male reproductive proteins on obstetrical outcomes in women is largely unstudied. Epidemiologic and clinical observations suggest that shorter-duration exposure to MRPs prior to conception may elevate the risk for preeclampsia. A limited literature has also linked sexual behavior to bacterial vaginosis and preterm birth. We offer a clinical opinion that MRPs may have broad implications for successful reproduction, potentially involved in the composition of vaginal microflora, risks of preterm birth and preeclampsia, and success of assisted reproduction. (author's) Language: English Keywords: GLOBAL | CRITIQUE | SPERMATOZOA | SEMEN | PROTEINS | REPRODUCTION | REPRODUCTIVE BEHAVIOR | VAGINOSIS | PREECLAMPSIA | PREMATURE BIRTH | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Seminal Vesicles | Genitalia, Male | Fertility | Population Dynamics | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Pregnancy Complications | Pregnancy Outcomes | Pregnancy Document Number: 327027 |
| 24. Peer Reviewed Title: Risk factors for bacterial vaginosis incidence in young adult Thai women. Author: Rugpao S; Sriplienchan S; Rungruengthanakit K; Lamlertkittikul S; Pinjareon S Source: Sexually Transmitted Diseases. 2008 Jul;35(7):643-648. Abstract: The objective of this study was to determine risk factors for incident bacterial vaginosis (BV) in young Thai women. Prospective data from a cohort of 1522 women aged 18 to 35 years, who were enrolled in a study of hormonal contraception and HIV acquisition, were used to evaluate potential risk factors for BV, as diagnosed by Amsel criteria. The median prevalence of BV from 3 to 24 months of follow-up visits was 2.5%. The BV incidence was 10.0 per 100-woman years. Statistically significant factors in multivariable analysis were sex during menstruation [hazard ratio (HR), 1.80; 95% CI, 1.11-2.92], male partners having sex with other women (HR, 2.3; 95% CI, 1.45-2.98), cigarette smoking (HR, 1.79; 95% CI, 1.08 -2.98), and trichomoniasis (HR, 15.68; 95% CI, 4.95-49.68). Intravaginal practices were not associated with incident BV in unadjusted or adjusted analysis. This study supports the association between sexual behaviors and the incident BV. Failure to detect an association between intravaginal practices and incident BV warrants further studies in high-risk populations or in women with a higher prevalence of intravaginal practices. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | COHORT ANALYSIS | WOMEN | VAGINOSIS | PREVALENCE | RISK FACTORS | SEX BEHAVIOR | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Studies | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Measurement | Biology | Behavior Document Number: 327516 |
| 25. Title: Local profile of cytokines and nitric oxide in patients with bacterial vaginosis and cervical intraepithelial neoplasia. Author: Tavares-Murta BM; de Resende AD; Cunha FQ; Murta EF Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2008 May;138(1):93-99. Abstract: The objective was to evaluate the local immune response in patients with bacterial vaginosis (BV) and cervical intraepithelial neoplasia (CIN), as assessed by cytokine and nitric oxide (NO) concentrations. Patients attending for routine gynaecological examination were prospectively enrolled in groups: BV (n = 25) diagnosed by clinical criteria, CIN graded I to III (n = 35, 6 CIN I, 8 CIN II and 21 CIN III) by histological analysis, and controls (n = 15) without clinical and cytological findings. Randomly selected patients within CIN group at grades II or III (n = 15) were re-evaluated at 60 days after surgical treatment. Endocervical (EC) and vaginal secretion samples were collected by cytobrush and the levels of cytokines (ELISA) and NO metabolite (Griess reaction) were assayed. NO was assessed in all subjects, and cytokines in all controls, 15 BV and 30 CIN patients. Interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and nitrite levels were higher in EC than in vaginal secretionsin BVand CIN groups. In CIN group, IL-8, IL-10 and nitrite concentrations were greater in EC and/or vaginal secretions than in BV or controls. Surgical treatment reduced IL-8 levels in EC and vaginal secretions. A similar local immune profile was found in BVand CIN groups. The increased local production of IL-8, IL-10 and NO in CIN suggests a role for these mediators in the immune response against tumour or tumour development. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | VAGINOSIS | BACTERIAL AND FUNGAL DISEASES | CERVICAL CANCER | CYTOLOGIC EFFECTS | PHYSICAL EXAMINATIONS AND DIAGNOSES | LABORATORY EXAMINATIONS AND DIAGNOSES | HISTOCHEMICAL EFFECTS | GYNECOLOGIC SURGERY | IMMUNOLOGIC FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Vaginal Abnormalities | Diseases | Infections | Cancer | Neoplasms | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Urogenital Surgery | Surgery | Treatment | Immunity | Immune System Document Number: 326443 |
| 26. Title: Herpes simplex virus and HIV-1: deciphering viral synergy. Author: Van de Perre P; Segondy M; Foulongne V; Ouedraogo A; Konate I Source: Lancet Infectious Diseases. 2008 Aug;8(8):490-497. Abstract: Recent proof-of-concept randomised controlled trials have shown a causal relation between herpes simplex virus (HSV) type 2 infection and HIV-1 replication in co-infected individuals. We explore the mechanisms that may operate to enhance reciprocal viral replication. Direct interactions could involve HIV-1-related immune defi ciency, disruption of mucosal barrier by HSV infection/reactivation, HSV-induced mucosal cell recruitment, transactivation of HIV-1 replication by HSV proteins, and immune modulation by HSV decoys. Indirect interactions might coexist through disturbances of the vaginal fl ora during HSV shedding and systemic immune activation. In co-infected individuals, suppressive HSV treatment reduces HIV-1 genital and systemic excretion. This fi nding is a likely result of effi cacious prevention of HSV2 reactivations, and perhaps of other herpesviruses. Strategies to control HSV2 and other herpesviruses deserve urgent attention and should become part of the HIV-1 prevention and care package. Language: English Keywords: GLOBAL | LITERATURE REVIEW | DATA ANALYSIS | HIV | ANTIRETROVIRAL THERAPY | VAGINOSIS | HERPES GENITALIS | IMMUNOLOGICAL EFFECTS | LABORATORY PROCEDURES | TREATMENT | Research Methodology | HIV Infections | Viral Diseases | Diseases | Vaginal Abnormalities | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Immunity | Immune System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 327893 |
| 27. Peer Reviewed Title: Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women. Author: van de Wijgert JH; Morrison CS; Cornelisse PG; Munjoma M; Moncada J Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Jun 1;48(2):203-210. Abstract: The objective was to evaluate interrelationships between bacterial vaginosis (BV), vaginal yeast, vaginal practices (cleansing and drying/ tightening), mucosal inflammation, and HIV acquisition. A multicenter, prospective, observational cohort study was conducted, enrolling 4531 HIV-negative women aged 18 to 35 years attending family planning clinics in Zimbabwe and Uganda. Participants were tested for HIV and reproductive tract infections and were interviewed about vaginal practices every 3 months for 15 to 24 months. BV was measured by Gram stain Nugent scoring, vaginal yeast by wet mount, and mucosal inflammation by white blood cells on Gram stain. HIV incidence was 4.12 and 1.53 per 100 woman-years of follow-up in Zimbabwe and Uganda, respectively (a total of 213 incident infections). Women with BV or vaginal yeast were more likely to acquire HIV, especially if the condition was present at the same visit as the new HIV infection and the visit preceding it (hazard ratio [HR] = 2.50, 95% confidence interval [CI]: 1.68 to 3.72 and HR = 2.97, 95% CI: 1.67 to 5.28 for BV and yeast, respectively). These relationships did not seem to be mediated by mucosal inflammation. Vaginal drying/tightening was associated with HIV acquisition in univariate (HR = 1.49, 95% CI: 1.03 to 2.15) but not multivariate models. Vaginal cleansing was not associated with HIV acquisition. BV and yeast may contribute more to the HIV epidemic than previously thought. (author's) Language: English Keywords: AFRICA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | HETEROSEXUALS | CANDIDIASIS | HIV TESTING | VAGINOSIS | TRANSMISSION | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Bacterial and Fungal Diseases | Infections | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Abnormalities Document Number: 327236 |
| 28. Peer Reviewed Title: Evaluation of hygienic douching on the vaginal microflora of female sex workers. Author: Amaral R; Giraldo PC; Goncalves AK; Junior JE; Santos-Pereira S Source: International Journal of STD and AIDS. 2007 Nov;18(11):770-773. Abstract: To determine the frequency of abnormal vaginal flora and bacterial vaginosis (BV) in female sex workers (FSW) and the association between douching and vaginal microflora imbalance, a cross-sectional study enrolled 94 users and 61 non-users of vaginal douching. The social-demographic and sexual profile of these women was obtained and their abnormal vaginal flora, BV, vaginal candidiasis, trichomoniasis and cytolitic vaginosis on blinded samples were identified by Gram stain. A stepwise multivariate regression determined the risk of development of vaginal microflora imbalance. Prevalence of abnormal flora, BV, candidiasis, trichomoniasis and cytolytic vaginosis in the entire FSW was 75.5%, 51.0%, 5.1%, 0.64% and 1.9%, respectively. There were no significant differences in these findings between users and non-users of vaginal douching. Regression analysis did not identify any increased risk for altered vaginal flora or BV in vaginal douche users. In conclusion, vaginal douching did not increase the rate of these alterations in FSW. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SEX WORKERS | WOMEN | VAGINOSIS | CANDIDIASIS | BACTERIAL AND FUNGAL DISEASES | PREVALENCE | POSTCOITAL DOUCHING | HYGIENE | EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Sex Behavior | Behavior | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Infections | Measurement | Fertility Control, Postcoital | Family Planning | Public Health | Health Document Number: 321630 |
| 29. Title: Organisms associated with bacterial vaginosis in Nigerian women as determined by PCR-DGGE and 16S rRNA gene. Author: Anukam KC; Reid G Source: African Health Sciences. 2007 Jun;7(2):68-72. Abstract: Bacterial vaginosis (BV) is a condition with diverse etiology. This condition predisposes women to increased susceptibility to sexually transmitted diseases, including human immunodeficiency virus (HIV) infections and preterm birth. The diagnostic methods currently adopted in the evaluation of patient samples for BV are arguably Amsel criteria, and Nugent score that require microscopy and expert interpretation. These two methods are still subjective. The objective of this study was to determine the organisms present in the vagina of 34 HIV negative Nigerian women diagnosed as having bacterial vaginosis by using molecular techniques. The vaginal samples were subjected to DNA extraction, and amplified with eubacterial primers via PCR. The PCR products were separated using denaturing gradient gel electrophoresis (DGGE). Bands were excised, re-amplified, purified and sequenced. Sequence identification was performed using the BLAST algorithm and Genbank data base. Mycoplasma hominis (12/34; 35%) was the most common isolate and 9 (26%) contained one of two clones of an unusual Rainbow Trout intestinal bacterium, while unculturable Streptococcus sp, and other bacteria made up the remaining isolates. The findings indicate further diversity in the etiological agents associated with BV, and raise the question as to whether diagnosis and management of this condition needs to be re-evaluated in countries like Nigeria. There is some controversy over the clinical importance of BV, as it was once regarded as a disease caused by Gardnerella and presenting as an odourous discharge condition, but is now diagnosed without necessarily the presence of these organisms or signs. With the incidence of BV aligned to an increased risk of HIV in a country ravaged by this virus, the effective eradication of BV can only be achieved if appropriate therapies are delivered. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | VAGINOSIS | RISK FACTORS | SEXUALLY TRANSMITTED DISEASES | HIV | PREMATURE BIRTH | EXAMINATIONS AND DIAGNOSES | Studies | Research Methodology | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Biology | Reproductive Tract Infections | Infections | HIV Infections | Viral Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 319275 |
| 30. Title: Prevalence of bacterial vaginosis among women in Delhi, India. Author: Bhalla P; Chawla R; Garg S; Singh MM; Raina U Source: Indian Journal of Medical Research. 2007 Feb;125(2):167-172. Abstract: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age. Surveillance studies on bacterial vaginosis are mostly based on specialist clinic settings. As few population-based prevalence surveys of bacterial vaginosis have been conducted, we studied the prevalence of bacterial vaginosis in the urban and rural communities in Delhi, and to associate the presence of bacterial vaginosis with demoraphic profile, risk factors and presence of other reproductive tract infections (RTIs)/ sexually transmitted infections (STIs). Vaginal specimens for Gram-stain evaluation of vaginal flora for diagnosis of bacterial vaginosis and culture of Trichomonas vaginalis and Candida spp, blood samples for HIV and syphilis serology, and urine for detection of Neisseria gonorrhoeae and Chlamydia trachomatis were collected from women (15-49 yr) from rural and urban areas. Information on demographic characteristics, risk factors and clinical symptoms was obtained. Bacterial vaginosiswas diagnosed in 70 (32.8%) subjects. A high percentage though asymptomatic (31.2%) were found to have bacterial vaginosis. Highest prevalence was seen in urban slum (38.6%) followed by rural (28.8%) and urban middle class community (25.4%). All women with vaginal trichomoniasis were found to have bacterial vaginosis while 50 per cent of subjects having syphilis also had bacterial vaginosis. The study showed high prevalence of bacterial vaginosis. The asymptomatic women having bacterial vaginosis are less likely to seek treatment for the morbidity and thus are more likely to acquire other STIs. Women attending various healthcare facilities should be screened and treated for bacterial vaginosis to reduce the risk of acquisition of other STIs. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | BACTERIAL AND FUNGAL DISEASES | VAGINOSIS | PREVALENCE | SCREENING | SEXUALLY TRANSMITTED DISEASES | SYPHILIS | SIGNS AND SYMPTOMS | GEOGRAPHIC FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Infections | Diseases | Vaginal Abnormalities | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections Document Number: 317584 |
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