ABSTRACT
AIM: To identify risk factors associated with and evaluate algorithms for predicting Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) cervical infections in women attending family planning clinics in Thailand. METHODS: Eligible women were recruited from family planning clinics from all regions in Thailand. The women were followed at 3-month intervals for 15-24 months. At each visit, the women were interviewed for interval sexually transmitted infection (STI) history in the past 3 months, recent sexual behavior, and contraceptive use. Pelvic examinations were performed and endocervical specimens were collected to test for CT and NG using polymerase chain reaction. RESULTS: Factors associated with incident CT/NG cervical infections in multivariate analyses included region of country other than the north, age Subject(s)
Chlamydia Infections/epidemiology
, Chlamydia trachomatis/isolation & purification
, Gonorrhea/epidemiology
, Mass Screening/methods
, Neisseria gonorrhoeae/isolation & purification
, Uterine Cervical Diseases/epidemiology
, Adolescent
, Adult
, Algorithms
, Ambulatory Care Facilities/statistics & numerical data
, Cervix Uteri/microbiology
, Chlamydia Infections/microbiology
, Epithelium/microbiology
, Female
, Gonorrhea/microbiology
, Humans
, Predictive Value of Tests
, Risk Factors
, Thailand/epidemiology
, Uterine Cervical Diseases/microbiology
, Young Adult
ABSTRACT
OBJECTIVE: To determine risk factors for incident bacterial vaginosis (BV) in young Thai women. STUDY DESIGN: Prospective data from a cohort of 1522 women aged 18 to 35 years, who were enrolled in a study of hormonal contraception and HIV acquisition, were used to evaluate potential risk factors for BV, as diagnosed by Amsel criteria. RESULTS: The median prevalence of BV from 3 to 24 months of follow-up visits was 2.5%. The BV incidence was 10.0 per 100-woman years. Statistically significant factors in multivariable analysis were sex during menstruation [hazard ratio (HR), 1.80; 95% CI, 1.11-2.92], male partners having sex with other women (HR, 2.3; 95% CI, 1.45-2.98), cigarette smoking (HR, 1.79; 95% CI, 1.08-2.98), and trichomoniasis (HR, 15.68; 95% CI, 4.95-49.68). Intravaginal practices were not associated with incident BV in unadjusted or adjusted analysis. CONCLUSIONS: This study supports the association between sexual behaviors and the incident BV. Failure to detect an association between intravaginal practices and incident BV warrants further studies in high-risk populations or in women with a higher prevalence of intravaginal practices.
