Use of copper intrauterine device is not associated with higher bacterial vaginosis prevalence in Thai HIV-positive women^*

* Study team: Chonthicha Muangma, Jaravee Jamthong, Yosita Kaewchongoen, Rosalin Kriengsinyot, Somsong Teeratakulpisarn, Tippawan Pankam, Yada Kunpalin, Yanisar Chanpoon, Kanitta Pussadee, Kamonthip Langevattana, Wanida Ratchasee, Orathai Chaiya, Ratchadaporn Meksena, Chatsuda Auchieng, Sumanee Nilgate, Nipat Teeratakulpisarn, Sasiwimol Ubolyam, Tanakorn Apornpong, Jintanat Ananworanich, Nadia Kancheva Landolt, Nittaya Phanuphak and Surasith Chaithongwongwatthana.

ABSTRACT

The study assessed and compared bacterial vaginosis (BV) prevalence in Thai women in reproductive age in four study groups – group 1, HIV-positive with copper intrauterine device (Cu-IUD); group 2, HIV-positive without Cu-IUD; group 3, HIV-negative with Cu-IUD; and group 4, HIV-negative without Cu-IUD. We conducted a cross-sectional study. BV prevalence was assessed by Nugent score and Amsel criteria. Descriptive statistics was used to present baseline characteristics; kwallis rank test – to compare variables between the four groups; logistic regression – to assess factors, related to BV prevalence. The analysis included 137 women in the four study groups with a median age of 39 years. Median BV prevalence by Nugent score was 45%, intermediate vaginal flora – 7% and normal vaginal flora – 48%. There was no statistically significant difference in the BV prevalence between the four study groups, p = 0.711. Threefold lower BV prevalence was found, assessed by Amsel criteria compared to Nugent score. Women with body mass index (BMI) < 20 had higher probability to have BV or intermediate vaginal flora, OR = 3.11, 95% CI (1.2–8.6), p = 0.025. The study found a high BV prevalence in the four study groups, related neither to HIV status, nor to Cu-IUD use. BV prevalence was associated only with low BMI. Thus, Cu-IUD could be a good contraceptive choice for HIV-positive women. Research in defining normal vaginal microbiota and improve diagnostic methods for BV should continue.

KEYWORDS:

• Bacterial vaginosis
• HIV
• copper intrauterine device
• contraception

Acknowledgements

The study was funded under the Cluster Ratchadapisek Sompotch Endowment Fund, Chulalongkorn University. We are grateful to the research and clinical staff and clients of the Thai Red Cross Anonymous Clinic, the HIV-NAT Clinic and the Family Planning Clinic, King Chulalongkorn Memorial Hospital.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Jintanat Ananworanich http://orcid.org/0000-0003-1369-3224

Notes

* Study team: Chonthicha Muangma, Jaravee Jamthong, Yosita Kaewchongoen, Rosalin Kriengsinyot, Somsong Teeratakulpisarn, Tippawan Pankam, Yada Kunpalin, Yanisar Chanpoon, Kanitta Pussadee, Kamonthip Langevattana, Wanida Ratchasee, Orathai Chaiya, Ratchadaporn Meksena, Chatsuda Auchieng, Sumanee Nilgate, Nipat Teeratakulpisarn, Sasiwimol Ubolyam, Tanakorn Apornpong, Jintanat Ananworanich, Nadia Kancheva Landolt, Nittaya Phanuphak and Surasith Chaithongwongwatthana.

Additional information

Funding

This work was supported by Cluster Ratchadapisek Sompotch Endowment Fund, Chulalongkorn University.