Table 2.
Risk Factors for Bacterial Vaginosis among Female Sex Workers in Mombasa, Kenya (Gram Stain Criteria)
| Characteristic | Univariate | Multivariate without Lactobacillus | Multivariate including Lactobacillus | |||
|---|---|---|---|---|---|---|
| HR (95% CI) | P | HR (95% CI) | P | HR (95% CI) | P | |
| Agea | 0.80 (0.73–0.89) | <0.001 | 0.78 (0.70–0.86) | <0.001 | 0.78 (0.70–0.86) | <0.001 |
| Years of sex worka | 0.93 (0.81–1.06) | 0.3 | ||||
| Education <8 years | 1.06 (0.91–1.24) | 0.5 | ||||
| Bar workerb | 1.02 (0.85–1.23) | 0.8 | ||||
| Tobacco use | 1.11 (0.89–1.37) | 0.4 | ||||
| Alcohol use | 1.15 (0.95–1.39) | 0.2 | ||||
| Vaginal washing frequency | ||||||
| None | 1.0 | 1.0 | 1.0 | |||
| 1–14 times per week | 1.29 (0.96–1.72) | 0.09 | 1.29 (0.88–1.89) | 0.2 | 1.31 (0.89–1.91) | 0.2 |
| 15–28 times per week | 1.47 (1.08–1.99) | 0.01 | 1.60 (0.89–2.61) | 0.06 | 1.65 (1.01–2.70) | 0.05 |
| >28 times per week | 1.94 (1.36–2.76) | <0.001 | 2.39 (1.35–4.23) | 0.003 | 2.41 (1.36–4.27) | 0.003 |
| Test for trend | --- | 0.02 | --- | 0.04 | --- | 0.03 |
| Vaginal washing substance | ||||||
| None | 1.0 | 1.0 | 1.0 | |||
| Water | 1.18 (1.01–1.38) | 0.04 | 0.95 (0.74–1.22) | 0.7 | 0.93 (0.73–1.20) | 0.6 |
| Soap or antisepticc | 1.17 (1.00–1.38) | 0.06 | 0.89 (0.69–1.15) | 0.4 | 0.87 (0.68–1.12) | 0.3 |
| Cloth to clean inside vagina | 1.58 (1.17–2.14) | 0.003 | 1.48 (1.06–2.08) | 0.02 | 1.50 (1.07–2.12) | 0.02 |
| Bathes <14 times per week | 0.73 (0.52–1.04) | 0.08 | 0.84 (0.59–1.21) | 0.4 | 0.81 (0.57–1.17) | 0.3 |
| Vaginal lubricant for sex | ||||||
| None | 1.0 | 1.0 | 1.0 | |||
| Vaseline | 1.39 (1.07–1.79) | 0.01 | 1.22 (0.95–1.55) | 0.1 | 1.26 (0.99–1.60) | 0.06 |
| Saliva | 1.04 (0.49–2.24) | 0.9 | 0.95 (0.50–1.80) | 0.9 | 0.94 (0.49–1.80) | 0.9 |
| Sex partners in last week | ||||||
| None | 1.0 | 1.0 | 1.0 | |||
| One | 1.38 (1.16–1.95) | <0.001 | 0.95 (0.77–1.16) | 0.6 | 0.94 (0.77–1.16) | 0.6 |
| More than one | 1.55 (1.24–1.95) | <0.001 | 0.97 (0.74–1.26) | 0.8 | 0.94 (0.73–1.23) | 0.7 |
| Unprotected sex in last week | 1.66 (1.43–1.92) | <0.001 | 1.75 (1.47–2.08) | <0.001 | 1.72 (1.44–2.06) | <0.001 |
| New partner in past month | 1.23 (1.01–1.51) | 0.04 | 1.18 (0.95–1.47) | 0.1 | 1.19 (0.96–1.48) | 0.1 |
| Contraception | ||||||
| None or tubal ligation | 1.0 | 1.0 | ||||
| OCP | 1.34 (1.06–1.68) | 0.01 | 1.20 (0.96–1.50) | 0.1 | 1.18 (0.94–1.48) | 0.2 |
| DMPA | 0.59 (0.48–0.73) | <0.001 | 0.59 (0.48–0.73) | <0.001 | 0.60 (0.48–0.74) | <0.001 |
| Norplant | 0.91 (0.54–1.55) | 0.7 | 0.89 (0.60–1.30) | 0.5 | 0.97 (0.66–1.42) | 0.9 |
| IUD | 1.28 (0.57–2.84) | 0.5 | 1.59 (0.74–3.40) | 0.2 | 1.80 (0.90–3.62)) | 0.1 |
| Neisseria gonorrhoeae | 0.39 (0.06–2.43) | 0.3 | ||||
| Cervicitisd | 1.25 (0.74–2.11) | 0.4 | ||||
| Vaginal candidiasis | 0.40 (0.27–0.59) | <0.001 | 0.41 (0.28–0.60) | <0.001 | 0.42 (0.29–0.62) | <0.001 |
| Trichomonas vaginalis | 1.73 (1.13–2.66) | 0.01 | 1.83 (1.17–2.84) | 0.008 | 1.78 (1.14–2.76) | 0.01 |
| Lactobacilluse | ||||||
| None | 1.0 | --- | 1.0 | |||
| H2O2-negative only | 0.65 (0.47–0.90) | 0.01 | --- | 0.70 (0.52–0.94) | 0.02 | |
| H2O2-positive | 0.58 (0.38–0.89) | 0.01 | --- | 0.64 (0.42–0.99) | 0.04 | |
NOTE: Hazard ratios are based on Andersen-Gill proportional hazards analysis. aHR, adjusted hazard ratio; CI, confidence interval; DMPA, depot medroxyprogesterone acetate; H2O2, hydrogen peroxide; HR, hazard ratio; IUD, intrauterine device; OCP, oral contraceptive pill.
Per ten years.
Bar work has been associated with an increased risk of sexually transmitted infections and HIV acquisition in the Mombasa Cohort 1.
Use of antiseptics was reported at <2% of visits.
Average polymorphonuclear leukocyte count ≥30 cells per high power field on microscopy of Gram stained cervical secretions.
Lactobacillus species identified on vaginal culture in the prior 60 days.