Vaginal infections in human immunodeficiency virus–infected women

Abstract

Objective: This study was undertaken to compare the frequencies of vaginal infections among human immunodeficiency virus–infected women with those among human immunodeficiency virus–seronegative women. Study Design: Human immunodeficiency virus–seropositive women attending a comprehensive care center for human immunodeficiency virus disease at the outpatient department of an inner-city hospital in Houston underwent rigorous gynecologic evaluation for sexually transmitted diseases, including evidence of vaginal infections such as bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis. Demographic information was collected, as was information regarding disease classification and degree of immunosuppression. Data regarding sexually transmitted diseases, data regarding vaginal infections, and demographic information were collected from a cohort of human immunodeficiency virus–seronegative women attending a sexually transmitted disease and family planning clinic at the same institution. The two groups were compared to determine whether there were any differences between them in the frequencies of sexually transmitted diseases and vaginal infection. Data analysis used the t test for parametric data and the Fisher exact test for nonparametric data where appropriate. P <.05 was considered significant. Statistical analysis was performed with the SAS (SAS Institute, Inc, Cary, NC) statistical software package. Results: There was no difference in age between the 2 groups. The human immunodeficiency virus–infected group was predominantly African American (80.5%), whereas the human immunodeficiency virus–seronegative control group was more evenly divided between African American women (45.8%) and Latinos (41.7%; P <.0001). Although there was no significant association between HIV infection and sexually transmitted diseases in general, there were significant associations between human immunodeficiency virus infection and bacterial vaginosis (P =.02), vulvovaginal candidiasis (P =.001), and trichomonal vaginitis (P =.003). Conclusion: Human immunodeficiency virus–infected women had increased frequencies of vaginal infections, including bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis, with respect to human immunodeficiency virus–seronegative control subjects. No differences between the 2 groups were seen in the frequencies of sexually transmitted diseases. (Am J Obstet Gynecol 2000;183:347-55.)