Bacteria 'down there' linked to HIV

Bacterial vaginosis increases risk of female to male HIV transmission

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) At the beginning of the AIDS epidemic, HIV was universally a man's disease - spread among men in the gay community. Today, women constitute half of the world's infections. Why?

Researchers have found that the risk of a woman transmitting HIV to a male partner is three times higher if she has bacterial vaginosis.

Bacterial vaginosis is a condition in which harmful bacteria disrupt the normal microbial community in the vagina.

"Women with HIV should get checked for bacterial vaginosis."

The study was led by Dr. Craig R. Cohen, a professor of obstetrics, gynecology and reproductive sciences at the University of California – San Francisco. Previous studies have already established that bacteria vaginosis (BV) increases a woman's chances of contracting HIV by 60 percent.

Dr. Cohen wanted to know if BV also increased a women's ability to transmit the disease.

BV is a very common disorder among women of childbearing age. In Sub-Saharan Africa, where the study was conducted, it's estimated that up to half of HIV-infected women have BV.

It's not known exactly how women get BV, but it's suspected that having a new sex partner or douching can bring it on.

What it means is that the normal and healthy community of bacteria in the vagina has been disrupted by harmful bacteria.

Many women with BV experience no symptoms. It must be diagnosed by a lab test, and the standard treatment is a course of antibiotics.

BV is generally associated with other sexually transmitted diseases besides HIV. For pregnant women, it causes preterm births and low birth weights.

Because the condition is so common in women with HIV in Africa – the epicenter of the modern AIDS crisis – the researchers hope that diagnosing BV can help reduce transmission. For women in abusive relationships, insisting on safe sex is not always an option.

The team studied 2,236 HIV positive women and their uninfected male partners from seven African countries. The women were routinely tested for BV and the men were tested for HIV.

After controlling for other factors, they found that BV was associated with a 3.17-fold increased risk of HIV transmission. “These findings suggest that bacterial vaginosis could be responsible for a substantial proportion of new HIV infections in Africa,” the authors wrote.

The study concludes that providing treatment for BV with antimicrobials or probiotics (which they call, “live 'good' bacteria”) might reduce female-to-male HIV transmission in one of the riskiest regions for HIV/AIDS.

Currently, only a fifth of HIV positive people in Sub-Saharan Africa are receiving treatment with antiretroviral drugs.

The study was published in PLoS Medicine in June 2012.

Reviewed by: 
Review Date: 
June 27, 2012
Last Updated:
November 27, 2012