Bacterial vaginosis, race, and sexually transmitted infections: Does race modify the association?
Bacterial vaginosis, race, and sexually transmitted infections: Does race modify the association?
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DOI：
10.1097/olq.0b013e31815e4179
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发表时间：
2008-04-01
影响因子：
3.1
通讯作者：
Stein, Michael D.
中科院分区：
文献类型：
--
作者：
Peipert, Jeffrey F.;Lapane, Kate L.;Stein, Michael D.
背景：美国性传播感染（STI）患病率存在显着的种族差异。本研究的目的是评估即使在调整了性行为和其他潜在混杂变量后，细菌性阴道病和性传播感染事件之间的关联是否会因种族而改变。 方法：我们评估了 523 名意外怀孕和性传播感染高风险女性中细菌性阴道病 (BV) 和性传播感染之间的关联。 BV的诊断采用革兰氏染色和Amsel标准。性传播感染包括沙眼衣原体、淋病奈瑟菌、盆腔炎、滴虫病、梅毒和艾滋病毒。 Cox 回归估计了这些关联，协同指数评估了种族是否改变了 BV 和性传播感染事件之间的关联。结果：16% 的参与者在 2 年随访期间出现了性传播感染。与基线时没有 BV 的白人女性相比，调整后的风险比如下： BV 的白人女性 = 0.59；没有 BV 的非裔美国女性 = 1.96；非洲裔美国女性的 BV = 2.86。协同指数 3.38 意味着 BV 和非裔美国人种族与 STI 的综合关联超过了各个因素的单独关联。结论：非裔美国人种族改变了 BV 和突发性 STI 的关联。未来的研究应努力确定其他因素在这种差异中的相对贡献，例如生物变异、社会网络或社会经济地位的后果。
Background: There are significant racial disparities in the prevalence of sexually transmitted infections (STIs) in the United States. The purpose of this study was to evaluate whether the association of bacterial vaginosis and incident STI is modified by race even after adjustment for sexual practices and other potential confounding variables.Methods: We evaluated the association of bacterial vaginosis (BV) and STI acquisition in a group of 523 women at high risk for unplanned pregnancies and STI. BV was diagnosed by both Gram stain and Amsel criteria. STIs included Chlamydia trachomatis, Neisseria gonorrhoeae, pelvic inflammatory disease, trichomoniasis, syphilis, and HIV. Cox regression estimated the associations and the synergy index assessed whether race modified the association of BV and incident STI.Results: Sixteen percent of participants developed an STI during the 2-year follow-up. Compared with white women without BV at baseline, the adjusted hazard ratios were as follows: white women with BV = 0.59; African American women without BV = 1.96; and African American women with BV = 2.86. The synergy index of 3.38 implies a combined association of BV and African American race with STI in excess of each factor individually.Conclusions: African American race modifies the association of BV and incident STI. Future research should strive to determine the relative contributions of other factors, such as biologic variation, social network or the consequences of socioeconomic position, in this disparity.