Bacterial Vaginosis in Lesbians: A Sexually Transmitted Disease

Abstract

Sexual transmission of bacterial vaginosis (BV), a common syndrome in sexually active women, has not been previously established. Because no male counterpart for BV has been found, a population of lesbians is an ideal one in which to test the hypothesis that BV is sexually transmitted. We studied 103 homosexual women (lesbians) who sought gynecologic care at a community clinic and in a private gynecology practice in New York City. Participants were asked to refer their sexual partners for evaluation. In this cross-sectional prevalence study, all participants were evaluated for the presence of BV, and pairs of monogamous sexual partners were analyzed for concordance of their vaginal secretions. Twenty-nine (28.7%) of the 101 participants from whom satisfactory vaginal wash samples were available had BV. There were 21 pairs of monogamous partners. Of 11 index women who had BV, eight (72.7%) had partners who also had BV. Of 10 index women who did not have BV, only one (10%) had a partner with BV. The likelihood of a partner's having BV was 19.7 times greater if the index case had BV (P < .008; 95% CI, 2.1-588.0). We conclude that with respect to BV, lesbians in monogamous relationships usually have concordant vaginal secretions. This concordance probably reflects the sexual transmission of BV between lesbians.

A Multicenter Study of Bacterial Vaginosis in Women With orat Risk for Human Immunodeficiency Virus Infection

“…The relationship with having had sex with a female is consistent with some evidence that female-tofemale transmission of bacterial vaginosis occurs. In a small study of 21 lesbian couples, 72% of partners of women with bacterial vaginosis also had bacterial vaginosis, compared with only 10% of partners of those without bacterial vaginosis 38 .…”

Sexually Transmitted Infections and Associated Conditions Among Women Who Have Sex with Women

“…Moreover, Marrazzo and colleagues, utilizing rep-PCR to characterize vaginal isolates among 30 monogamous (defined within the timeframe of the prior 3 months) female sex partners, revealed that 23 of these couples shared identical strains of Lactobacillus. Finally, other studies have demonstrated that BV is frequently found in both members of monogamous lesbian couples and BV concordance within couples has been associated with specific sexual behaviors, including shared use of vaginally penetrative sex toys [57,58].…”

Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective

“…The concordance of BV status in monogamous lesbian couples ranges up to 95% (53,54), strongly suggesting that BV is sexually associated, although an infectious correlate has not been identified (55). Menses, a new sexual partner, vaginal douching, receptive oral sex, and lack of condom use are among the strongest risk factors for BV (54,(56)(57)(58)(59)(60)(61)(62)(63).…”