A common vaginal issue, bacterial vaginosis (BV), is now being recognized as a sexually transmitted infection (STI), according to a recent study. The research, published in The New England Journal of Medicine, suggests that men whose female partners experience BV may also require treatment. This marks a shift in understanding BV, previously thought to be only a women’s health concern.
BV occurs when there is an imbalance in the bacteria in the vagina. It is typically linked to factors such as new or multiple sexual partners. The study confirms that sexual activity can introduce or spread the bacteria responsible for the condition. Left untreated, BV can increase the risk of acquiring other STIs, including HIV, and can lead to complications during pregnancy and childbirth. BV is also the most common cause of vaginal discharge among women of reproductive age. Until now, there has been no proven method to prevent the infection.
About one-third of women worldwide will experience BV in their lifetime, with many facing recurrent infections. Symptoms include itching, discharge, a fishy odor, and burning during urination. More than half of women with BV will see a recurrence within three months of completing a weeklong course of antibiotics.
Experts have long suspected that BV might be an STI due to its similarities to other sexually transmitted infections, such as chlamydia. Like many STIs, BV is associated with a change in sexual partners and lack of condom use. In a study conducted in Australia, 164 couples participated. The women had BV and were in monogamous relationships with male partners. The couples were randomly assigned to one of two treatment protocols: one group received antibiotics for the woman only, while the other treated both partners with antibiotics and a topical antimicrobial cream for the man. The study was halted early when it became clear that treating only the woman was less effective. In the women whose partners were not treated, the recurrence rate was 65%, compared to 35% in the women whose partners received treatment.
The study’s authors stress that while BV has been challenging to understand, advances in genomic sequencing are helping identify the bacteria responsible. The results from this study show clear evidence that BV-associated bacteria are sexually transmitted.
An editorial accompanying the study emphasized the need for a shift in how BV is treated and how women are counseled about the infection. It calls for including male partners in the treatment and prevention process. For now, the only proven way to reduce the sexual transmission of BV is consistent condom use.
