The role of sexual networks in studies of how BV and STIs increase the risk of subsequent reinfection

C. Kenyon, J. Buyze, M. Klebanoff, R. M. Brotman

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Abstract

Prior studies have demonstrated that both bacterial vaginosis (BV) and sexually transmitted infections (STIs) are strong independent risk factors for subsequent STI. In observational studies of this biological enhancement (BE) hypothesis, it is important to adjust for the risk of STI exposure so that the independent effect of BE can be assessed. We sought to model if two markers of local sexual network (partner concurrency and cumulative number of STIs) represented residual confounding in the models of risk for subsequent infection in a study that screened 3620 women for STIs every 3 months for a year. Mixed-effects logistic regression was used to calculate the odds ratios for an incident diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and BV following a diagnosis of any of these four at the prior visit, controlling for the cumulative number of STIs and partner concurrency variables. We found that partner concurrency and cumulative number of STIs were each associated with incident infection, and in general, controlling for these variables reduced the strength of the association between prior and incident infections. We conclude that the frequently found association between prior and incident STIs is associated with both BE and sexual network structure.

Original languageEnglish
JournalEpidemiology and Infection
Volume146
Issue number15
Pages (from-to)2003-2009
Number of pages7
ISSN0950-2688
DOIs
Publication statusPublished - 2018

Keywords

  • Bacterial vaginosis
  • chlamydia
  • gonorrhoea
  • partner concurrency
  • residual confounding
  • sexual network
  • Trichomonas vaginalis
  • BACTERIAL VAGINOSIS
  • HIV-INFECTION
  • PARTNERSHIP CONCURRENCY
  • TRANSMITTED INFECTIONS
  • GRAM STAIN
  • EPIDEMIOLOGY
  • TRANSMISSION
  • ASSOCIATION
  • DISEASES

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