A groundbreaking study has redefined bacterial vaginosis (BV)—a condition affecting nearly a third of women globally—as a sexually transmitted infection (STI). This revelation could revolutionize how BV is treated, bringing new hope for reducing recurrence rates and complications associated with the condition, such as infertility, premature births, and newborn deaths.
The study by the researchers at the Melbourne Sexual Health Centre, part of Monash University and Alfred Health, challenged the traditional view of BV as an imbalance in the vaginal microbiome.
Current treatments focus only on women, leading to over half of cases recurring within three months of antibiotic therapy. However, the study showed that treating both sexual partners simultaneously drastically improves cure rates.
In a trial involving 164 couples in monogamous relationships, researchers found that treating BV as an STI—providing both partners with antibiotics—reduced recurrence rates by 50% compared to treating women alone. The trial was even halted early due to the apparent success of the partner-treatment approach.
“This successful intervention is relatively cheap and short and has the potential to not only improve BV cure rates but also to open up exciting possibilities for prevention,” said Professor Bradshaw.
The men in the partner-treatment group were given oral antibiotics and a topical cream that addressed bacterial reservoirs on the penile skin—an area overlooked in previous studies. This was critical to achieving higher cure rates for women.
BV’s status as a likely STI has long been suspected due to its risk factors, which mirror those of other STIs like chlamydia.
“We’ve suspected for a long time that it’s sexually transmitted because of its incubation period and association with changes in sexual partners or condom use,” said Dr. Vodstrcil.
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Previous studies dismissed the sexual transmission theory due to limited trial designs. Still, this research fills the gaps with evidence showing that reinfection by untreated partners significantly contributes to BV recurrence. Advances in genomic sequencing are also helping researchers pinpoint the specific bacteria responsible for BV.
These results have already led to changes in clinical practice at the Melbourne Sexual Health Centre, where couples are now treated together.
A new website for health professionals and consumers provides guidance on partner treatment to ensure broader accessibility. While updates to national and global treatment guidelines may take time, the researchers were eager to make this information available as soon as their findings were published.
“This discovery is a major step forward,” Professor Bradshaw said. “It not only improves how we treat BV but also offers a pathway for preventing its serious complications.”
This research underscores the importance of treating BV as an STI, marking a pivotal moment in women’s sexual health and paving the way for more effective care worldwide.
Journal Reference
Lenka A. Vodstrcil, Erica L. Plummer, Christopher K. Fairley et al. Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis. New England Journal of Medicine. DOI: 10.1056/NEJMoa2405404