Study Identifies New STI Linked to Bacterial Vaginosis in Women

A recent study indicates that bacterial vaginosis (BV), a condition impacting nearly one-third of women globally, is a sexually transmitted infection (STI). This revelation has significant implications for treatment strategies, particularly in addressing the high rates of recurrence observed in affected women.

Research conducted by Monash University and Alfred Health at the Melbourne Sexual Health Center has been published in the New England Journal of Medicine. The authors of the study argue that the traditional approach to treating BV, which views it as merely an imbalance in the vaginal microbiome, fails to address the underlying causes of its recurrence.

In their trial involving 164 couples in monogamous relationships, researchers discovered that administering treatment to both partners simultaneously resulted in notably higher cure rates compared to the conventional method of treating only the women. The study was halted early due to the clear evidence that treating male partners significantly reduced the recurrence of BV in women.

Professor Catriona Bradshaw, a lead author of the study, emphasized the importance of this intervention, highlighting its cost-effectiveness and short duration. This new approach not only enhances the chances of curing BV in women but also provides a promising avenue for preventing the serious complications associated with the condition.

During the trial, all participating women received standard antibiotic treatment. In contrast, their male partners were randomly assigned to either receive a comprehensive treatment regimen, which included both oral and topical antibiotics, or to a control group that received no treatment. The latter group followed the existing global guidelines, which typically recommend treating only the female partner.

Both groups were monitored for 12 weeks to assess the effectiveness of the treatment in curing BV. The findings revealed that the incidence of BV recurrence was significantly lower in the group where both partners were treated.

Additionally, researchers noted that BV increases the risk of contracting other STIs, aligning with previous suspicions regarding its nature as a sexually transmitted infection. The condition shares common risk factors with STIs, such as changes in sexual partners and inconsistent condom use.

While earlier studies had suggested that men might host bacterial species linked to BV, they failed to demonstrate improved cure rates in women when male partners were included in the treatment. Professor Bradshaw pointed out that flaws in the design of those studies, including the lack of comprehensive treatment for men, contributed to the misunderstanding of BV's transmission dynamics.

Advancements in genomic sequencing are aiding researchers in pinpointing the specific bacteria responsible for BV, addressing one of the challenges in establishing its status as an STI. The results of this study have prompted changes in clinical practices at the Melbourne Sexual Health Center, which now recommends treatment for both partners.

To facilitate this shift, a new resource has been developed for healthcare professionals and patients, providing comprehensive information on prescribing and accessing partner treatment. This initiative was created in collaboration with trial participants and healthcare providers to ensure accessibility and clarity.

Changes to national and international treatment guidelines may take time, but the researchers are committed to providing accurate and timely information to help combat BV effectively.