After a groundbreaking study in The New England Journal of Medicine revealed that bacterial vaginosis (BV), which affects almost one-third of women globally, can be spread through sexual contact, important questions still need to be answered. In addition to calling for more research on the condition that can lead to infertility, premature births, and newborn deaths, the study findings may change the focus of treatment from women-only information about bacterial vaginosis (BV) to both men and women. results of the investigation. The study.

Vodstrcil’s team discovered that treating bacterial vaginosis (BV) as an STI and treating both sexual partners at the same time resulted in noticeably higher cure rates than the current practice of treating only women in a trial of 164 couples in which each woman had BV and was in a monogamous relationship with a male partner.

According to a press release from coauthor Catriona S. Bradshaw, PhD, who is also affiliated with the Melbourne Sexual Health Centre at Monash University, this effective intervention is brief, reasonably priced, and has the potential to improve bacterial vaginosis (BV) treatment for women for the first time. It also creates exciting new opportunities for BV prevention.

The male partners in the partner-treatment group received oral and topical antimicrobial treatment (400 mg metronidazole tablets and 2 percent clindamycin cream applied to penile skin, twice daily for 7 days) while the women in the randomized, open-label, controlled trial received first-line recommended antimicrobial agents. In the control group, male partners were not treated while women received first-line care. Recurrence of bacterial vaginosis (BV) within 12 weeks was the main result. The researchers pointed out that historically, after taking oral antibiotics for a week, over half of women with bacterial vaginosis (BV) have a recurrence within three months.

35 percent of women in the partner-treatment group and 63 percent of women in the control group experienced a recurrence of bacterial vaginosis (BV) in the modified intention-to-treat population. This represents an absolute risk difference of −2.6 recurrences per person-year (95 percent CI, −4.0 to −1.2; P < .001). According to the authors, the trial was terminated early because the woman’s treatment alone was subpar compared to that of both her and her male partner. Other Factors May Affect the Development of Bacterial Vaginosis (BV) Nevertheless, some experts highlight unresolved issues that demand more investigation.

While he believes that bacterial vaginosis (BV) can definitely be spread through sexual contact, Mykhaylo Usyk, PhD, MPH, MSci, a research assistant professor in the Departments of Microbiology and Immunology, Department of Pediatrics at the Albert Einstein College of Medicine in the Bronx, New York, stated that further research is necessary to determine which specific types of BV are transmissible, particularly since the trial was not finished for ethical reasons. Recurrence was not prevented for every individual who received the intervention, and the sample size was small.

According to Usyk, who published a study on the impact of bacterial vaginosis (BV) on chlamydia infection recurrence, I’m not sure if I would classify BV as an STI in and of itself. Similar to a fever, bacterial vaginosis (BV) is also an indicator. It is a sign of another illness. He stated that it is evident that men are serving as a reservoir. The men have some underlying infections that will cause bacterial vaginosis (BV) to recur unless they are treated. Usyk stated that he would like to see more research on which subtype of bacterial vaginosis (BV) is transmissible before routinely prescribing antibiotics to men and women to treat and prevent BV. Douching and smoking may be factors.

Other contributing factors, like smoking or intravaginal practices like douching and using lubricants, may also disrupt the vaginal microbiome and contribute to the development of bacterial vaginosis (BV), according to Rebecca Brotman, PhD, MPH, who studies the human vaginal microbiome and bacterial vaginosis (BV) at the Center for Advanced Microbiome Research and Innovation at the University of Maryland School of Medicine, Baltimore. She agreed that the trial’s findings will change how doctors treat and care for bacterial vaginosis (BV) and said it offers strong evidence in favor of the long-held theory that BV-associated bacteria can be sexually transmitted. She pointed out that there was little proof that men could spread bacterial vaginosis (BV) before the trial was published.

She did, however, note that although the trial is a major step forward in the treatment of bacterial vaginosis (BV), more research is required to confirm the results in other populations. For instance, a third of the women in the trial were using intrauterine devices, and 80% of the men were not circumcised. These factors can both have an impact on the presence of bacteria linked to bacterial vaginosis (BV). She cites numerous studies that support the idea that bacterial vaginosis (BV) can be sexually transmitted, including the high concordance in lesbian couples, the frequent co-occurrence of BV with STIs, the higher prevalence among women who have multiple or new sexual partners, and the higher incidence among women whose male partners have multiple recent partners.

According to her, studies show that women who regularly use condoms or refrain from having sex have a lower risk of contracting bacterial vaginosis (BV), while unprotected sex is associated with a higher rate of treatment failure. As the director of the Vulvovaginal Disorders Program at Massachusetts General Hospital in Boston, Caroline M. Mitchell, MD, MPH, told Medscape Medical News, “A Huge Win for Women,” it’s crucial to keep in mind that bacterial vaginosis (BV) is a syndrome, meaning that different bacteria may be present in different people or episodes.

Clinically, I do see patients who appear to have highly sexually facilitated bacterial vaginosis (BV), which only occurs with one partner and goes away when they are not with that person. Others, however, do not feel this way at all. This isn’t universal, in my opinion. I do encounter patients who have attempted abstinence but continue to experience recurrence. In contrast to chlamydia, I do not believe that a person’s partner is being unfaithful if they have BV. However, the results of this study indicate that bacteria on the penis probably contribute to at least some cases of bacterial vaginosis (BV), which does appear to be sexually facilitated.

I do believe that there may be some passing back and forth of BV-associated bacteria between sexual partners for people with highly recurrent bacterial vaginosis (BV), and that treating both people as [recommended] in this paper will be necessary to clear those organisms,” she continued. She claimed that the study represents a significant advancement in the prevention of bacterial vaginosis (BV) recurrence in certain patients. This is a major victory for women, she said, because the field’s treatment options haven’t changed significantly since 1982. The results should alter counseling.

In an editorial that goes with it, Christina A. According to Jack D. Dot Sobel, MD, of the Division of Infectious Diseases at Wayne State University in Detroit, and Muzny, MD, MSPH, of the Division of Infectious Diseases at The University of Alabama at Birmingham, the results should alter counseling for women. According to the editorialists, the results also highlight the need for a significant shift in the way that women with bacterial vaginosis are treated, specifically in terms of counseling them about the cause of their infection and involving their male partners in sharing responsibility for treatment and transmission. Other than using condoms consistently, there are currently no effective methods to stop the sexual spread of bacteria linked to bacterial vaginosis.

The StepUp Australian New Zealand Clinical Trials Registry and the National Health and Medical Research Council of Australia provided funding for this study. The complete text of the papers is available along with the disclosures made by the authors and editorialists. Usyk disclosed no pertinent financial ties. Brotman disclosed no pertinent financial ties. Mitchell was granted stock options and serves on the scientific advisory boards of Concerto Bio and Ancilia Bio. Up to Date paid royalties to her.