An investigation led by the University of California - San Francisco has found that the risk of female-to-male HIV transmission is increased three fold for women with bacterial vaginosis, a common disorder in which the normal balance of bacteria in the vagina is disrupted. The study appears in the journal PLoS Medicine.
Bacterial vaginosis occurs when the normal balance of microorganisms naturally found in the vagina is altered. This disruption of vaginal flora takes place when bacteria that are helpful are reduced and more harmful bacteria are increased.
"Previous research has shown that bacterial vaginosis can increase a women's risk of becoming infected with HIV as much as sixty percent. Our study is the first to show that the risk of transmitting HIV is also elevated. Our findings point to the need for additional research to improve the diagnosis and treatment of bacterial vaginosis, which is extremely common in sub-Saharan Africa, the region of the globe with the highest burden of HIV," said the study's lead author, Craig R. Cohen.
The new research involved 2,236 HIV positive women and their uninfected male partners from seven African countries. After controlling for socio-demographic factors, sexual behavior, male circumcision, sexually transmitted infections, pregnancy and levels of HIV in the blood of the women with HIV, bacterial vaginosis was associated with a significantly increased risk for female-to-male transmission of HIV.
"We looked at the increased shedding of HIV in the genital tract, but that was not sufficient to explain the increased risk of female-to-male HIV transmission. It is also possible that bacterial vaginosis causes inflammation and that could be a factor. We don't really understand the relationship between vaginal flora and inflammation," said Cohen.
Notwithstanding the need for better understanding of the role of vaginal flora, the development of more therapeutics for bacterial vaginosis, including better drugs and probiotics, would be a significant boost to women's health in general, as well as help decrease HIV acquisition and transmission risks, added Cohen.
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Source: University of California - San Francisco