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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Mar;95(3):201–212.

Can known risk factors explain racial differences in the occurrence of bacterial vaginosis?

Roberta B Ness 1, Sharon Hillier 1, Holly E Richter 1, David E Soper 1, Carol Stamm 1, Debra C Bass 1, Richard L Sweet 1, Peter Rice 1
PMCID: PMC2594421  PMID: 12749680

Abstract

BACKGROUND: Black women are more likely to have bacterial vaginosis (BV) than are non-Hispanic white women. We examined whether this disparity can be explained by racial differences in known BV risk factors. METHODS: Nine hundred black and 235 white women were enrolled from five US sites. At baseline, structured interviews were conducted and vaginal swabs self-collected for Gram-stain and culture. RESULTS: Black women were more likely than white women to have BV/intermediate vaginal flora. They also were more likely to be older, have lower educational attainment and family incomes, have a history of a sexually transmitted disease, and douche. After adjustment for demographic and lifestyle factors, blacks remained at elevated risk for BV/intermediate flora (OR 2.2, 95% CI 1.5-3.1). Blacks also were more likely to have specific BV-related vaginal microflora, as well as gonococcal or chlamydial cervicitis (OR 2.2, 95% CI 1.2-3.8) after adjustment for known BV risk factors. CONCLUSION: Risk factor differences did not explain the observed racial disparity in the occurrence of BV, BV-related microflora, or gonococcal or chlamydial cervicitis. These findings highlight our limited understanding of the factors accounting for the occurrence of bacterial vaginosis and cervicitis among black and white women.

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Selected References

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