Bacterial vaginosis, ethnicity, and the use of genital cleaning agents: A case control study

Background and Objectives: Bacterial vaginosis and vaginal douching are bot h reported to be more common in African-American and Caribbean than white w omen. It is also thought that douching alters the vaginal milieu. This stud y was conducted to examine associations between genital cleaning practices, bacterial vaginosis, and ethnic group. Study Design: Case-control study of 100 women with bacterial vaginosis, dia gnosed by Nugent's criteria, and 100 women without bacterial vaginosis atte nding a sexually transmitted diseases clinic in an ethnically heterogeneous inner-city area in London, England. Results: Bacterial vaginosis was more common among black Caribbean than whi te women (OR, 2.1; 95% CI, 1.1-4.1). Vulval use of bubble bath or antisepti c solutions and douching with proprietary or homemade solutions were signif icantly more common in women with bacterial vaginosis than without. After c ontrolling for use of vulval and vaginal antiseptics and bubble bath, douch ing, and a history of bacterial vaginosis, there was no ethnic difference i n the occurrence of the condition (adjusted OR, 1.1; 95% CI, 0.5-2.5). Conclusions: Ethnic differences in genital hygiene behaviors can explain a twofold increase in the risk of bacterial vaginosis in black Caribbean comp ared with white women. The role of vulval and vaginal cleaning practices in the development of bacterial vaginosis should be examined further in longi tudinal or randomized controlled studies.