ArticleBMJ open2015
A cross-sectional study of bacterial vaginosis, intravaginal practices and HIV genital shedding; implications for HIV transmission and women's health.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03134924 (Vaginal Practices in Human Immunodeficiency Virus), which is not on this map. Cited by 16 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Vaginal Practices in Human Immunodeficiency Virus (HIV) Positive Women in Zambia, a Bio-Behavioral Intervention "WASH-2"
Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- A bio-behavioral intervention to decrease intravaginal practices and bacterial vaginosis among HIV infected Zambian women, a randomized pilot study.BMC infectious diseases · 2017Trial
- Genital tract infections, antiretroviral treatment and HIV-1 viral load in early postpartum women: : implications for sexual and breastfeeding HIV transmission.BMC infectious diseases · 2026Article
- Bacterial Vaginosis and Post-Operative Pelvic Infections.Healthcare (Basel, Switzerland) · 2023Review
- A Syndemic Approach to Explore Factors Associated with Bacterial Vaginosis.AIDS and behavior · 2022Article
- Altered Innate Immunity and Damaged Epithelial Integrity in Vaginal Microbial Dysbiosis.Frontiers in reproductive health · 2022Article
- Article
- Characterizations of Bacterial Vaginosis among HIV-Positive and HIV-Negative Women in Rural Eastern Cape Province, South Africa.International journal of microbiology · 2021Article
- Impact of vaginal microbiome communities on HIV antiretroviral-based pre-exposure prophylaxis (PrEP) drug metabolism.PLoS pathogens · 2020Article
- Intravaginal practices among young HIV-infected women in Lusaka, Zambia.International journal of STD & AIDS · 2018Article
- Article
- Risk of heterosexual HIV transmission attributable to sexually transmitted infections and non-specific genital inflammation in Zambian discordant couples, 1994-2012.International journal of epidemiology · 2017Article
- Bacterial vaginosis, human papilloma virus and herpes viridae do not predict vaginal HIV RNA shedding in women living with HIV in Denmark.BMC infectious diseases · 2017Article
- Vaginal HIV-1 shedding among HIV-1 infected women in the current era of combined antiretroviral therapy: A cross sectional study.Virulence · 2017Article
- Intravaginal Practices and Prevalence of Sexual and Reproductive Tract Infections Among Women in Rural Malawi.Sexually transmitted diseases · 2016Article
- Pathogenesis of Bacterial Vaginosis: Discussion of Current Hypotheses.The Journal of infectious diseases · 2016Review
- Exploring the Vaginal Microbiome and Intravaginal Practices in Postmenopausal Women.Nursing researchArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesBacterial vaginosis (BV) is associated with an increased risk of HIV transmission, and intravaginal practices (IVP) are an important risk factor for developing BV. The relationship between IVP, BV and HIV lower genital shedding, responsible for HIV transmission, has not been examined in women receiving antiretrovirals in Zambia.
designCross-sectional study.
settingCommunity Health Center in Lusaka, Zambia. PARTICIPANTS AND
methodsParticipants were HIV-infected women receiving antiretroviral therapy and engaging in IVP (n=128). Participants completed audio computer-administered self-interviews to assess IVP and underwent a vaginal examination. BV was diagnosed using Nugent criteria. HIV-1 lower genital shedding was assessed by measuring HIV-1 RNA in cervicovaginal lavages.
resultsMost women engaged in IVP daily (114, 89.0%) and 81 (63.3%) of the participants had BV. HIV-1 genital shedding was detected in 18 (14.2%) participants. BV was associated with daily use of IVP (prevalence ratio, PR=4.58, CI 1.26 to 16.64, p=0.02) and weekly use of traditional medicines for IVP (PR=1.33, CI 1.05 to 1.68, p=0.02). The only factor associated with HIV-1 lower genital shedding was plasma viraemia (PR=4.61, CI 2.02 to 10.54, p<0.001). Neither IVP nor BV were associated with HIV shedding.
conclusionsDespite the frequency of IVP and high prevalence of BV, plasma viraemia was the primary factor associated with HIV lower genital shedding. These findings support early initiation of antiretrovirals as an HIV prevention tool. Given adverse health outcomes associated with BV, the association between frequent IVP and BV, and the powerful local norms and traditions encouraging IVP, there is a need for studies assessing culturally tailored interventions to decrease BV in high-prevalence settings.
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