High rate of bacterial vaginosis among women with intrauterine devices in Manado, Indonesia

Recent research reported that bacterial vaginosis (BV) might enhance the ac quisition and transmission of HIV. BV is also associated with an increased risk of pelvic inflammatory disease, a disease also associated with intraut erine device (IM) insertion. To measure the magnitude of this problem, we c onducted a prevalence survey of BV and sexually transmitted diseases (STDs; defined as current infections with Neisseria gonorrhoeae, Chlamydia tracho matis, and/or Trichomonas vaginalis) among all patients attending a family planning clinic in Manado from May to July 1999. BV was diagnosed by Gram s tain using Nugent's criteria and vaginal trichomoniasis by wet mount or cul ture. Cervical infections with C. trachomatis and N. gonorrhoeae were diagn osed by DNA probe. Of 357 patients, 116 (32.5%) had BV, 83 (23.3%) had tric homoniasis, 9 (2.5%) had chlamydia, and 8 (2.2%) had gonorrhea. The prevale nce of STD was similar among users of all types of contraception. However, BV was more common among IUD users (47.2%) than among non-IUD users (29.9%) . This association persisted after controlling for age, education, ever had douching, and any STD (odds ratio 2.0, 95% CI 1.1-3.8). BV was also associ ated with STD (41.3% in women with STD vs. 29.4% in women without). This as sociation remained significant after adjusting for age, education, ever had douching, and IUD use (odds ratio 1.7, 95% Cl 1.1-2.9). Because we found t hat BV was associated with IUDs and that other studies reported that both B V and IUDs were associated with pelvic inflammatory disease, a Gram stain e valuation of BV may be considered prior to IUD insertion. (C) 2001 Elsevier Science Inc. Ali rights reserved.