Table 2.
Risk Factors for Vulvovaginal Candidiasis in HIV-1-Seronegative Kenyan Women
| Visits with VVC | Visits without VVC | Univariate | Multivariate | |||
|---|---|---|---|---|---|---|
| Variable | n = 162 | n = 1408 | OR (95% CI) | P | OR (95% CI) | P |
| Age | ||||||
| ≤20 years | 12 (7.4%) | 14 (1.0%) | 1.0 | |||
| 21-30 years | 64 (39.5%) | 514 (36.5%) | 0.12 (0.03, 0.49) | 0.003 | ||
| 31-40 years | 57 (35.2%) | 609 (43.3%) | 0.09 (0.02, 0.39) | 0.001 | ||
| >40 years | 29 (17.9%) | 271 (19.2%) | 0.10 (0.02, 0.47) | 0.004 | ||
| Overall P-value (Wald Test) | 0.02 | |||||
| Years of sex worka | ||||||
| ≤ 5 years | 120 (74.5%) | 789 (56.5%) | 1.0 | 1.0 | ||
| 5-10 years | 16 (9.9%) | 335 (24.0%) | 0.38 (0.19, 0.73) | 0.004 | 0.39 (0.19, 0.80) | 0.01 |
| 10-15 years | 16 (9.9%) | 145 (10.4%) | 0.55 (0.29, 1.91) | 0.5 | 0.67 (0.26, 1.71) | 0.4 |
| >15 years | 9 (5.6%) | 128 (9.2%) | 0.46 (0.13, 1.63) | 0.2 | 0.24 (0.05, 1.24) | 0.09 |
| Overall P-value (Wald Test) | 0.03 | |||||
| Education ≤8 years | 109 (67.3%) | 858 (60.9%) | 1.39 (0.84, 2.31) | 0.2 | ||
| Vaginal washing frequency | ||||||
| None | 17 (10.5%) | 163 (11.6%) | 1.0 | |||
| 1-14 times/week | 82 (50.6%) | 744 (52.8%) | 1.11 (0.62, 1.98) | 0.7 | ||
| 15-28 times/week | 56 (34.6%) | 411 (29.2%) | 1.19 (0.63, 2.25) | 0.6 | ||
| >28 times per week | 7 (4.3%) | 90 (6.4%) | 0.83 (0.32, 2.12) | 0.7 | ||
| Overall P-value (Wald Test) | 0.8 | |||||
| Vaginal washing substanceb | ||||||
| None | 17 (10.5%) | 163 (11.6%) | 1.0 | |||
| Water | 99 (61.1%) | 778 (55.3%) | 1.17 (0.79, 1.74) | 0.4 | ||
| Soap or antiseptic | 101 (62.3%) | 864 (61.4%) | 0.97 (0.65, 1.44) | 0.9 | ||
| Overall P-value (Wald Test) | 0.7 | |||||
| Cloth to clean inside the vagina | 6 (3.7%) | 37 (2.6%) | 1.32 (0.63, 2.76) | 0.5 | ||
| Bathes <14 times per week | 11 (6.8%) | 95 (6.7%) | 1.34 (0.71, 2.54) | 0.4 | ||
| Sex partners in last week | ||||||
| None | 74 (45.7%) | 522 (37.1%) | 1.0 | 1.0 | ||
| One | 74 (45.7%) | 710 (50.4%) | 0.74 (0.55, 1.01) | 0.06 | 0.77 (0.54, 1.09) | 0.1 |
| More than one | 14 (8.6%) | 176 (12.5%) | 0.52 (0.26, 1.04) | 0.07 | 0.60 (0.30, 1.24) | 0.2 |
| Overall P-value (Wald Test) | 0.08 | |||||
| Unprotected sex in the last week | 34 (21.0%) | 370 (26.3%) | 0.71 (0.45, 1.11) | 0.1 | 0.95 (0.58, 1.55) | 0.8 |
| New partner in the past month | 17 (10.5%) | 187 (13.3%) | 0.98 (0.58, 1.64) | 0.9 | ||
| Contraceptionc | ||||||
| None or tubal ligation | 95 (58.6%) | 904 (64.5%) | 1.0 | |||
| OCP | 9 (5.6%) | 98 (7.0%) | 1.31 (0.40, 4.27) | 0.7 | ||
| DMPA | 53 (32.7%) | 352 (25.1%) | 1.52 (0.85, 2.74) | 0.2 | ||
| Norplant | 3 (1.9%) | 41 (2.9%) | 0.95 (0.41, 2.17) | 0.9 | ||
| IUD | 2 (1.2%) | 9 (0.6%) | 1.18 (0.80, 1.74) | 0.4 | ||
| Overall P-value (Wald Test) | 0.6 | |||||
| Neisseria gonorrhoeae | 0 (0%) | 6 (0.4%) | NC | |||
| Cervicitisd | 4 (2.5%) | 17 (1.2%) | 2.04 (0.73, 5.68) | 0.2 | ||
| Bacterial vaginosise | 25 (15.4%) | 528 (37.5%) | 0.27 (0.15, 0.49) | <0.001 | 0.29 (0.16, 0.50) | <0.001 |
| Trichomonas vaginalis | 2 (1.2%) | 20 (1.4%) | 1.32 (0.48, 3.65) | 0.6 | ||
| Lactobacillus culture positivee | 23 (14.2%) | 125 (8.9%) | 1.34 (0.70, 2.57) | 0.4 | ||
| Antibioticsf | ||||||
| None | 145 (89.5%) | 1241 (88.1%) | 1.0 | |||
| Oral metronidazoleg | 6 (3.7%) | 25 (1.8%) | 1.24 (0.22, 7.11) | 0.8 | ||
| Other antibacterialsh | 13 (8.0%) | 147 (10.4%) | 0.69 (0.33, 1.44) | 0.7 | ||
| Antifungalsi | 5 (3.1) | 17 (1.2%) | 1.36 (0.24, 7.75) | 0.7 | ||
| Overall P-value (Wald Test) | 0.5 | |||||
Note: DMPA, depot medroxyprogesterone acetate; H2O2, hydrogen peroxide; HR, hazard ratio; IUD, intrauterine device; NC, no convergence; OCP, oral contraceptive pill.
Data on years of sex work was missing for 12 visits.
There were 452 visits at vaginal washing with both water and soap/antiseptic were reported.
Data on contraception were missing at 6 visits. Because of the extended window of effect for contraceptives, women who changed methods could contribute to more than one category at some visits.
Average polymorphonuclear leukocyte count ≥30 cells per high power field on microscopy of Gram stained cervical secretions.
Bacterial vaginosis and Lactobacillus included analysis visit only.
60 day effect window for vaginal yeast colonization and antibiotics did not include analysis visit.
Metronidazole was dispensed at 28 visits.
The most common prescriptions for other antibacterials included amoxicillin (55), cloxacillin (31), doxycycline (19), and trimethoprim-sulfamethoxazole (16), ciprofloxacin (7), and norfloxacin (6). Other oral antibacterials, prescribed less than 5 times each, included erythromycin, benzathine penicillin, amoxicillin with clavulanate, and levofloxacin.
There were 20 prescriptions for clotrimazole vaginal pessaries and 2 prescriptions for nystatin vaginal pessaries.