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Bacterial vaginosis, a common vaginal infection also known as BV, has long been treated as a women’s condition; but a new study adds to evidence that it is a sexually transmitted infection and suggests that treating a male partner can help reduce recurrence.
BV affects nearly 1 in 3 women of reproductive age globally. It has been associated with increased risk of adverse birth outcomes, HIV and other sexually transmitted infections, according to the World Health Organization. It has a high recurrence rate, with more than half of those who are treated experiencing the condition again within three months.
The study, led by a team of Australian researchers, was published in the New England Journal of Medicine on Wednesday. It involved 164 monogamous male-female couples. About half were assigned to the partner treatment group, where the female partners received standard treatment and male partners were given oral and topical cream antibiotics. In the control group, only the female partners received treatment.
In the partner treatment group, 35 percent of women experienced recurrence, compared with 63 percent in the control group.
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“Our trial has shown that reinfection from partners is causing a lot of the BV recurrence women experience, and provides evidence that BV is in fact an STI,” Catriona Bradshaw, a professor at Monash University and an author on the study, said in a statement.
Jen Balkus, an infectious-disease epidemiologist who studies sexual and reproductive health at the University of Washington, called the results “paradigm-shifting” and said they “open the door to changes in clinical guidance for BV treatment — especially for women with a history of recurrent BV.”
She said they are “particularly exciting as the researchers were finally able to address a long-standing question in the field.”
Lenka Vodstrcil, a senior research fellow at Monash University and the lead author on the paper, explained that among researchers, BV “has long been thought of as sexually transmitted” and there has been a lot of evidence to support this. However, previous trials that also treated men failed to show improvements in women with BV and were “taken as evidence that BV was not an STI.”
Vodstrcil said in an email that the researchers believe previous treatment studies, which did not include topical cream, overlooked BV bacteria on the penile skin.
Symptoms of BV include unusual discharge, odor, itching and burning during urination.
“It is fair to say that because this condition has only caused symptoms and issues in women that it has not got the same attention that it would have if both sexes were equally affected,” Vodstrcil added.
Craig Cohen, a professor of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco, wrote in an email that in the study, “what is novel is the use of dual male partner treatment — oral and topical antibiotics.” Such findings will be important, he wrote, because “there are no FDA-approved (yet) treatments to reduce recurrence.”
Cohen said he expects these findings will be included when the Centers for Disease Control and Prevention reviews its guidelines on sexually transmitted infections.
Bradshaw was optimistic about the findings, adding that the intervention has the potential to “not only improve BV cure for women, but opens up exciting new opportunities for BV prevention, and prevention of the serious complications associated with BV.”