Official websites use. Share sensitive information only on official, secure websites. Corresponding Author: King K. Phone: ; FAX: ; worthy u. Bacterial vaginosis BV recurs frequently after metronidazole treatment. In the intervention arm, male partners agreed to apply gel each morning, and before and after sexual intercourse. All couples received counseling, condoms, and syndromic treatment of STI symptoms. Follow-up visits were scheduled 1 week, 1 month, and 2 months post-enrollment, with vaginal Gram stains at every visit and culture for H 2 O 2 -producing lactobacilli at the 2 month visit.
The primary outcome was time to diagnosis of BV during follow-up. In the primary intent-to-treat analysis, diagnosis of BV was significantly more frequent in the intervention arm Hazard ratio 1. After adjustment for baseline covariates, the hazard ratio was 1. However, no difference was observed in prevalences of vaginal lactobacilli within this same period.
In bacterial vaginosis BV , anaerobic and facultative bacteria replace the normal, lactobacillus-dominated vaginal flora [ 1 ]. Molecular techniques have demonstrated a variety of new BV-associated bacterial species [ 2 ]. BV represents the most common cause of vaginal discharge symptoms among women of reproductive age and may cause considerable gynecologic and obstetric morbidity [ 1 , 3 - 8 ], and increase risk of acquisition of human immunodeficiency virus type 1 HIV-1 infection [ 9 - 12 ], especially in African women with high BV prevalence.
BV is associated with sexually transmitted infections STI , multiple or new sexual partners and recent sexual contact [ 13 - 16 ]. Inoculation of vaginal fluid from women with BV into the vaginas of non-infected women reproduced the syndrome [ 22 ]. In lesbian couples, BV concordance is associated with shared use of sex toys [ 23 ]. Following successful treatment with oral or intravaginal medication [ 24 ], BV commonly recurs within months [ 25 , 26 ].
Alternative treatments. Although oral probiotic use reportedly improved BV treatment [ 31 ], efforts to recolonize the vagina with lactobacilli during or following treatment of BV have given mixed results [ 32 ].
